Short Attention Span Summary
Are statewide mandates the way to go?
A statewide measure to mandate "best practices" for opiate prescribing in Washington reduced ED prescriptions by 1.5%. This was a very small change. Far better are local, departmental efforts, with buy in from the affected providers, as in the study covered earlier this month which had a 10% reduction in opiate prescriptions. The mandates are paraphrased here.
- Sharing of patient visits to other EDs
- Patient education to use the ED only for emergencies
- Lists of frequent flyers
- Help for frequent flyers
- "Strict" narcotic prescribing guidelines.
- Enrollment in the narcs database
- Review of ED utilization feedback reports
Statewide, non-specific mandates may help a little. Local and departmental policy change, with provider buy-in, is even better.
Impact of Hospital "Best Practice" Mandates on Prescription Opioid Dispensing after an Emergency Department Visit. Acad Emerg Med. 2017 May 23. doi: 10.1111/acem.13230. [Epub ahead of print]