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Quality and Patient Safety:


Quality/Patient Safety Goal:

Opioid Prescription Reduction in Orthopedic Surgical Patients

Goal & Summary

We are committed to eliminating any events of serious harm at Akron Children’s Hospital.

Why is this important?

In the past 15 years there has been a 350% increase in rates of opioid deaths in the United States. One of the contributors to opioid use and abuse is the over prescription of opioids by health care professionals, often associated with surgery. Additionally, the duration of opioid use is predictive for future opioid misuse. Across all age groups, orthopedic surgery accounts for one of the higher rates of opioid prescriptions. As a result, we sought to reduce the dose and duration of opioid prescriptions associated with orthopedic surgeries without reducing the effectiveness of postoperative pain control.

What are we doing to improve?

We developed a quality improvement team that established evidence-based care guidelines for specific types of orthopedic surgeries. We subsequently used the electronic health record to facilitate the implementation of postoperative guidelines when ordering pain medications. The group measured compliance with the guidelines and the overall prescription of opioids (morphine milligram equivalents = MME).

What progress have we made?

Opioids Prescribed in MME per Patient 2017-2019


Who are we partnering with to share best practices?

The outcomes of this project have been submitted for publication in Pediatrics, the peer-reviewed journal of the American Academy of Pediatrics (link to come on publication).

This improvement work was also adopted by the Pediatric Orthopedic Society of North America (POSNA)