The organization is fully committed to patient-centered care and actively focused on quality improvement through initiatives that will enhance patient outcomes. Quality improvement initiatives contribute to meeting internal goals of quality indicators as well as positively impacting patients and their families. This proposal will outline the initiative to reduce the rate of unnecessary antibiotics and opioid prescriptions by clinicians to vulnerable populations such as children, patients with a history of abuse, and those who may benefit from other treatments in order to reduce the risk of dependence or antibiotic resistance.
Medical drugs are meant to be an effective method of treatment and management of illness, commonly utilized as an intervention in healthcare. However, it has been determined that between 30 and 50 percent of medications are either not taken as intended or unnecessarily prescribed (NHS, 2015). This is inherently detrimental to patient outcomes as ineffective usage, antibiotics resistance, and opioid addiction are leading to a national health crisis.
It is vital to optimize and change current prescription practices to ensure safe use and better outcomes for patients. The choice and content of prescriptions ultimately depend on a clinician’s knowledge and attitudes towards medications. These factors can be influenced so that a physician has an increased understanding of the outcomes of their prescribing decisions. By comprehending the motivations and need for prescription medication, sustainable changes can be made to prescribing practices in healthcare. The purpose of this strategic initiative is to decrease unnecessary prescribing practices of antibiotics and opioids by clinicians in healthcare settings.
Behavioral interventions will be used, offering education on guidelines and effects of prescription drugs along with introducing control methods such as suggesting alternatives, peer comparison, and accountable justification from physicians (Meeker et al., 2016). As a result, the quality initiative hopes to reduce prescription rates through optimization of use while improving general patient outcomes as antibiotic resistance and opioid dependence will be reduced in the long term.
The target population for this initiative is any patient that may require treatment through the use of medication. However, certain populations may be more vulnerable. Therefore, it is vital that physicians recognize the risks and be able to identify such populations in order to promote other treatments. Children are the primary population that is at risk and has been the target of medicine safety campaigns.
Unnecessary exposure to antibiotics and opioids at an early age can have long-term health effects such as infection, obesity, hypertension, and asthmas. Furthermore, opioids present in some medicines such as cough syrup can lead to patterns of addiction in adulthood, while heavy antibiotics use modifies gut bacteria and results in bacterial resistance in the community (Hales, Kit, Gu, & Ogden, 2018).
Another target population is individuals who use drugs, had a history of addictions, and may be vulnerable to opioid abuse. The opioid crisis has reached epidemic levels as up to 29 percent of patients misuse prescribed opioids, and between 8 and 12 percent develop an addiction. More than 47,000 in the US die of an opioid overdose, and many transition to abuse of illegal drugs (National Institute on Drug Abuse, 2019). This indicates the need for a drastic change in prescribing practices of synthetic opioids and other prescription pain relievers.
A change to safer and optimized prescription practice has a wide variety of benefits that impact many areas of the health sector. First, as described earlier, patient outcomes and safety will be improved. A better prescription strategy of antibiotics and opioids, particularly with vulnerable populations, will reduce adverse drug events and prevent negative long-term health outcomes such as side effects, antibiotic resistance, or addictive behavior.
The initiative will enhance safe prescribing practices, which will lead to increased competency from clinicians regarding the assessment of patients and determining the need for prescription drugs. Furthermore, the initiative will have the benefit of creating cost savings for the hospital. The cost of medical drugs, as well as treatment of potential consequences of opioid and antibiotic misuse, reach hundreds of millions of dollars for the health system nationwide.
This has a trickle-down effect on local healthcare organizations as well, which are faced with the burden of higher 30-readmission rates, length of stay, and estimated hospital costs for opioid abuse patients (Gupta et al., 2018). The initiative has significant potential to reverse this trend and improve patient outcomes, hospital quality indicators, and community health.
As described above, the hospital costs of patients with adverse drug events such as opioid abuse are significantly higher. Furthermore, physicians often maintain poor awareness of prescription costs for both patients and the hospital, leading to high rates of these drugs being prescribed. High costs of medicines continue to place it as one of the leading expenses for the national healthcare sector. Combined, the costs of patient readmissions, long-term population effects, and unnecessary use of drugs exceed hundreds of thousands of dollars, even at a local level.
Meanwhile, introducing an inter-organization behavioral-educational intervention along with other controlling methods such as e-prescribing and peer verification will be relatively small. Many of these changes will improve hospital quality indicators and may be funded by funds that the health organization has set aside for quality improvement initiatives. Furthermore, these aspects are part of the national healthcare reform and guidelines which may improve funding from the government if the initiative is successful.
The ineffectiveness, misuse, or abuse of medical drugs in the United States has reached epidemic levels. One cause is clinician prescription of antibiotics and opioids when they are not necessary, leading to negative outcomes in vulnerable populations such as children and addicts. The proposed initiative offers behavioral and educational interventions with the hope to positively change prescription practices and improve patient outcomes and hospital quality indicators.
Gupta, A., Nizamuddin, J., Elmofty, D., Nizamuddin, S. L., Tung, A., Minhaj, M., … Shahul, S. (2018). Opioid abuse or dependence increases 30-day readmission rates after major operating room procedures. Anesthesiology, 128(5), 880–890. Web.
Hales, C. M., Kit, B. K., Gu, Q., & Ogden, C. L. (2018). Trends in prescription medication use among children and adolescents—the United States, 1999-2014. JAMA, 319(19), 2009-2020. Web.
Meeker, D., Linder, J. A., Fox, C. R., Friedberg, M. W., Persell, S. D., Goldstein, N. J., … Doctor, J. N. (2016). Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices. JAMA, 315(6), 562-570. Web.
National Institute on Drug Abuse. (2019). . Web.
NHS. (2015). Engaging clinicians in changing prescribing practice. Web.