Decreasing Opioid Use Postpartum: A Quality Improvement Initiative

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Public Health

Background:

• Opioid use in labor and delivery is a significant concern.
• Effective strategies are needed to reduce opioid dependence in postpartum patients.

Purpose of the Study:

• To evaluate the impact of a multimodal pain management initiative on opioid consumption in women admitted to labor and delivery.
• To assess changes in pain control and patient satisfaction following the initiative's implementation.

Main Methods:

• A multimodal pain management plan was implemented across five hospitals.
• The plan included therapeutic activity goals, scheduled NSAIDs, and EHR integration.
• Opioid use was compared before and after the plan's launch, with analyses stratified by delivery type.

Main Results:

• Opioid use decreased by 26% in vaginal deliveries and 18% in cesarean deliveries.
• Mean morphine milligram equivalent (MME) use reduced by 21% (vaginal) and 54% (cesarean).
• Fewer women reported acceptable pain levels post-initiative, with some reporting less pain control.

Conclusions:

• A standardized multimodal pain power plan effectively reduced opioid use in labor and delivery settings.
• Despite reduced opioid use, patient-reported pain control decreased, warranting further investigation.