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• W3090805972 abstract "Summary Introduction Opioid prescriptions have been implicated as one of the proximate causes of the national opioid epidemic. Children and adolescents and their families are at risk for increased opioid exposure through prescriptions after surgery. In pediatric urologic surgery, indications for postoperative opioids can vary widely and a focus on opioid stewardship is important to reduce potential harms. Objective To measure the efficacy of a quality improvement initiative aimed to reduce post-operative opioids for pain management in a large pediatric surgical cohort. Study design Patients undergoing ambulatory pediatric urologic surgery at a tertiary children's hospital between July 2016 to June 2019 were analyzed. Structured physician peer-to-peer comparisons, electronic health record redesign and a standardized pain management protocol were implemented. Rate of opioid prescriptions per month, utilization of non-opioid analgesia, unplanned encounters in the emergency department and/or office during implementation were aggregated. Opioid doses and prescribed opioid days before and after protocol implementation were analyzed. A subcohort, from October–December 2018 was administered a patient-reported outcome questionnaire focused on pain management and return to baseline activity. Results A total of 6684 consecutive outpatient urologic cases were included (median age = 3.3 years old (IQR 0.9–9.2) and 92.3% male). Comparing 6 months pre-intervention and the post-intervention latest 6 month intervals, opioid prescription rate decreased from 43.9% to 2.3% (p  Conclusion Opioid prescriptions and utilization may be minimized without increasing unplanned encounters or adversely affecting quality of life. The QI framework utilized in this process can be implemented to reduce opioid exposure in other surgical patient populations. Download : Download high-res image (352KB) Download : Download full-size image Summary Fig. . Proportion of cases per month with opioids prescribed (red), ketorolac administered (blue), ED visits within 30 days (purple) and office visits within 5 days (green)." @default.
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• W3090805972 date "2020-12-01" @default.
• W3090805972 modified "2023-09-24" @default.
• W3090805972 title "Reducing post-operative opioids in children undergoing outpatient urologic surgery: A quality improvement initiative" @default.
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• W3090805972 doi "https://doi.org/10.1016/j.jpurol.2020.09.022" @default.
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