Reducing Postoperative Opioids for Outpatient Endoscopic Urological Surgery: A Resident Driven Quality Improvement...

Area of Science:

• Urology
• Public Health
• Quality Improvement

Background:

• Opioid dependency is a major public health crisis in the U.S.
• Surplus opioid prescriptions post-surgery may exacerbate this issue.
• This study addresses opioid prescribing for outpatient urological surgery.

Purpose of the Study:

• To analyze opioid prescribing patterns in outpatient urological surgery.
• To reduce the quantity of prescribed opioids.
• To monitor patient outcomes after prescription adjustments.

Main Methods:

• Conducted a chart review and telephone survey of patients undergoing outpatient endourological surgery.
• Assessed prescribed vs. consumed opioid quantities (morphine milligram equivalents).
• Monitored emergency room visits, readmissions, and pain-related calls for 30 days post-initiative.

Main Results:

• Average opioid prescription reduced by 75.3% (from 156.6 to 38.6 MME).
• 71% of patients reported using no prescribed narcotics.
• No significant changes observed in ER visits, readmissions, or pain-related calls.

Conclusions:

• Resident-led quality improvement initiatives can effectively reduce surplus opioid prescriptions in urology.
• These initiatives contribute to decreasing local narcotic supply.
• Reducing opioid prescriptions is feasible without compromising patient pain management.