What You Should Know:
– Seattle Children’s Hospital and its Bellevue Clinic and Surgery Center (BCSC) leveraged AI-based technology from Seattle-based MDmetrix to develop the nation’s first “opioid-free” surgery center.
– The MDmetrix Mission Control platform was used to visualize and evaluate outcomes data so that physicians could quickly adapt their surgical protocols, incorporating evidence-based best practices, to effectively manage surgical pain while reducing patients’ opioid exposure.
– After their initial success in implementing opioid-sparing protocols for tonsillectomy and adenoidectomy surgeries, BCSC expanded their approach to include other surgeries—and quickly learned they could eliminate opioids for most types of outpatient surgery.
Seattle Children’s Hospital at its Bellevue Clinic and Surgery Center (BCSC) has developed the nation’s first-ever “opioid-free” surgery center. The “opioid-free” surgery center leverages MDmetrix’s artificial intelligence (AI)-driven technology empowering medical leaders and frontline clinicians to visualize, evaluate, and monitor clinical and workflow outcomes.
In Pursuit of an Opioid-Free Pediatric Ambulatory Surgery Center
Clinicians from BCSC recently published a groundbreaking study of their success in reducing opioid administration in the leading international anesthesia journal Anesthesia & Analgesia titled, “In Pursuit of an Opioid-Free Pediatric Ambulatory Surgery Center: A Quality Improvement Initiative.” As a result of this joint initiative between MDmetrix and Seattle Children’s, more than 6,000 pediatric patients at BCSC have successfully undergone opioid-free surgery. The new protocols use combinations of non-opioid multimodal pain medications such as dexmedetomidine, nonsteroidal anti-inflammatory drugs (NSAIDs) and regional anesthesia.
The MDmetrix Mission Control platform was used to visualize and evaluate outcomes data so that physicians could quickly adapt their protocols, incorporating evidence-based best practices, to effectively manage surgical pain while reducing patients’ opioid exposure. After their initial success in implementing opioid-sparing protocols for tonsillectomy and adenoidectomy surgeries, BCSC expanded their approach to include other surgeries—and quickly learned they could eliminate opioids for most types of outpatient surgery.
“Across the country, 5% of adolescents who undergo surgery become persistent opioid users,” said Greg Latham, MD, attending anesthesiologist at Seattle Children’s Hospital. “Surgery is a critical gateway to opioid misuse, so this is a tremendous breakthrough. MDmetrix’s technology allowed us to quickly implement evidence-based non-opioid alternatives, assess and adapt our anesthesia protocols, and dramatically improve care for our patients.”
Transforming Clinical Operations
As reported in the Anesthesia & Analgesia study, physicians at Seattle Children’s used MDmetrix to analyze more than 10,700 surgical cases. Based on insight from MDmetrix, the physicians developed protocols that eliminated opioid administration during surgery from the vast majority of their outpatient procedures (dropping from 84% to 8% of procedures), while also reducing the need for postoperative morphine administration from 11% to just 6%. With these new protocols, the clinicians found that postoperative nausea and vomiting—commonly caused by opioid administration—virtually disappeared, while pain scores, total anesthesia time, and total post-anesthesia care unit (PACU) time remained stable. Overall, costs also decreased, while patient/parent satisfaction increased dramatically.
BCSC’s quality improvement initiative with MDmetrix began in January 2018, with providers focusing on the reduction of opioid administration in pediatric tonsillectomies, which have typically relied on the intraoperative administration of opioids for pain management. The anesthesiologists from BCSC assembled a team to utilize a series of pain management protocols following the Plan-Do-Study-Act (PDSA) cycle, which is the standard methodology for the development of clinical improvements using real-world data.
“Using MDmetrix, we have been able to accelerate our PDSA-driven improvement work at a pace far beyond traditional methodologies,” Latham said. “With the MDmetrix Mission Control platform, we are improving protocols in weeks that we used to review across years. By enabling us to continuously monitor and evaluate outcomes across patients, MDmetrix has empowered our team to act on our data to implement a truly adaptive clinical management system.”
The opioid-free surgery initiative at BCSC is just one example of how MDmetrix’s clinical performance platform and AI tools are currently being used to transform clinical operations across hospitals and ambulatory surgery centers. Using the MDmetrix Mission Control platform, clinicians and healthcare leaders can visualize, compare, improve, and manage performance by team, protocol and/or facility across a wide array of metrics, including pain scores, procedure times and readmissions. As a result, providers have been empowered to transform patient care while also dramatically reducing resource utilization.