A Policy for the Care of Chronic Opioid Users with the Help of a Clinical Decision Support (CDS)

The opioid crisis in the United States has become abundantly clear and many initiatives have already begun to counteract its effects on society. Over 19.1 million opioid prescriptions were written each month from 2012 to 2017. Loyola does not currently have an opioid protocol in the ambulatory setting. The purpose of the project is to institute an opioid protocol with the help of an electronic health record (EHR) support tool. The quality improvement project will be implemented at three family medicine clinics at Loyola University over a five month period with the support from physicians, Advance Practice Nurses (APN) and behavioral health providers. Pre and post implementation data will be collected examining the rate of opioid’s prescribed from January 2020 to June 2020. Evaluation will include examining provider note elements and other elements included in the EHR support tool. Results are still pending, but will be completed by July 2020. The three main goals of the quality improvement project is to decrease the rate of opioid prescribing in the family medicine department, decrease prescriptions greater than 90 morphine milligram equivalent (MME) and decrease opioid and benzodiazepines prescribed simultaneously. The project aims to decrease opioid prescribing in a suburban family medicine department. It supports using a stepwise approach to chronic pain, management of chronic pain patients and support from an opioid protocol and EHR smart set. Overall, this will lead to better outcomes for patients and improved knowledge among Advance Practice Nurses (APN) and their physician/behavioral health colleagues.