Health System Collaboratives Lead to Care Improvement
November 5, 2018 | 4 min. to read
From averting falls to establishing new opioid-prescribing protocols and making information sharing easier, Health System Clinical Collaboratives are having a direct impact on patient care — and the clinician experience — by bringing together multidisciplinary teams to align best practices and enhance Epic in support of the Patients First mission. Clinicians at the center of decision-making Collaboratives are specialty-focused and clinically led, uniting physicians, nurses, subject matter experts and administrative leaders from each hospital with support staff from Informatics, Information Systems, Analytics, Quality and Performance Improvement. “I have been thrilled by how effective the initial Health System Clinical Collaboratives have been in getting clinicians together from all the NM hospitals to work on important clinical issues,” says Karl Bilimoria, MD, MS; John B. Murphy professor of surgery at Northwestern University Feinberg School of Medicine; vice president - Quality, Northwestern Medicine; director, Surgical Outcomes and Quality Improvement Center; and vice chair for Quality, Department of Surgery, Feinberg. “We expect great things from the launch of the remainder of the groups this fall.”
In addition to 14 currently active Clinical Collaboratives, 10 Business Collaboratives work to improve patient access, patient movement, health information management, value-based care and other areas.
Health System Clinical Collaboratives Work to Stem the Opioid Crisis Opioid overdoses have reached an all-time high nationally and locally, with nearly 30,000 opioid-related deaths in the U.S. in 2017, according to the Centers for Disease Control and Prevention. Northwestern Medicine is tackling this epidemic head-on by seeking to reduce the number of opioid prescriptions, promoting safe opioid disposal through drug take-back programs, educating caregivers and patients, and optimizing the electronic health record system to reflect new dosing and clinical decision support.
The General Surgery Health System Clinical Collaborative (HSCC), a multiregional group dedicated to improving surgical care, has been instrumental in better leveraging Epic to support physicians in guideline-based opioid prescribing, as well as reporting on individual prescribing practices.
“One of the strategies we are employing is to attack the opioid crisis at the initial opioid exposure for many patients — at the immediate time of their surgery and acute perioperative recovery,” says Michael McGee, MD, co-lead of the General Surgery HSCC. “Enhanced Recovery Pathway (ERP) programs developed through the Collaborative use cross-disciplinary approaches to deliver multimodal pain control strategies in order to decrease, and sometimes even eliminate, the need for opioids in the first place.”
A successful pilot of the colorectal surgery ERP program at Northwestern Memorial Hospital is leading to the development of a systemwide ERP program for use across disciplines. The pilot focused on:
Better education and management of patient expectations
Minimizing fasting before and after surgery
Minimizing opioids in favor of opioid-sparing pain medications
Minimizing IV fluids
Promoting early and frequent ambulation and convalescence
“We’re looking for surgical partners to make ERP the standard for their service,” says Dr. McGee. Going forward, the General Surgery HSCC will continue ERP-related work for most surgical specialties. “There is a lot more to come.”
You can view a list of members, recent decisions and more on the Health System Collaboratives page on NM Interactive at NMI > System Initiatives > Health System Collaboratives (login required). Questions or comments? Please email firstname.lastname@example.org.