Background: There were approximately 46,000 opioid overdose deaths in 2017. It is known that opioid overdose risk is increased in patients with a diagnosis of substance use disorder, prior opioid overdose, and high suspicion of risk as assessed by clinical teams. The Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) is a validated […]

Background: Prior studies have found racial disparities in how patients are assessed for pain and prescribed opioids from emergency department and surgical settings. However, we do not know whether similar disparities exist among general medicine inpatients. We examined opioid prescriptions at discharge among adults admitted to the general medicine service at our medical center, with […]

Background: The Pediatric Early Warning System (PEWS) is an established tool that aids in the identification of hospitalized patients at risk for clinical deterioration. Many pediatric institutions have adopted the PEWS as a patient safety initiative. At St. Louis Children's Hospital, it was initially deployed on the oncology unit in June 2011 and then subsequently […]

Background: The US has a heavy burden of deaths from opioid overdoses, and New Mexico is not excepted from this. Treatment options for opioid use disorder (OUD) are buprenorphine/naloxone (“Suboxone”), methadone, naltrexone, counseling, and/or behavioral therapy. Long-acting oral opioids like Suboxone, are the most effective methods for treating opioid withdrawal and OUD. They are often […]

Background: Persons with opioid use disorders (OUD) represent a disproportionately high percentage of hospitalized patients, have greater lengths of stay and readmissions, can incur higher costs, and are at greater risk of drug-related death immediately post-discharge. Further, despite the availability of effective medications for OUD, patients often are not offered treatment during the inpatient encounter. […]

Background: Transition from an acute care setting to a skilled nursing facility (SNF) or home is ripe with opportunities for poor communication. Changes in medications, lack of understanding about disease processes, and inadequate discharge teaching make patients vulnerable. Misunderstanding or lack of recognition can result in a readmission. Thus, 30‐day readmissions to the hospital are […]

Background: Prescription opioids have come under increasing scrutiny in recent years due to the rise in use and misuse which has resulted in significant morbidity and mortality. There have been several efforts by government agencies to address this such as the FDA issuing a Risk Evaluation Mitigation Strategy (REMS) for extended release/long acting (ERLAs) opioids […]

Background: The field of medicine is continuously evolving. Hospital medicine is in the forefront of transforming care delivery. To continuously improve practice, hospitalists need to participate in accredited continuing medical education (CME). Accredited CME is required for maintenance of licensure, credentialing, and other professional privileges. The Ongoing Professional Practice Evaluation (OPPE) is a regulatory requirement […]

Background: Pain management is a key quality indicator in hospital satisfaction surveys throughout the United States. Inadequate pain management contributes to longer inpatient length of stay, medical complications, inadequate healing, and dissatisfaction with the hospital experience. In the future, poor performance of the key quality indicators will translate into hundreds of thousands of dollars lost […]

Background: New Mexico has a long-standing history of implementing harm reduction strategies for the prevention of opioid overdose. Most recently, on June 14, 2019, SB221 added language to the New Mexico Pain Relief Act requiring health care providers prescribing opioid analgesics for 5 days or longer to co-prescribe an opioid antagonist along with written information […]