THUNDER BAY — The Thunder Bay Regional Health Sciences Centre has launched a pilot project as part of a broader effort to rein in Ontario's growing opioid crisis.
Thunder Bay has the highest rate of opioid-related deaths in the province, with as many as 29 fatalities in 2017. Analysis has shown that higher prescribing rates for opioids are closely associated with higher opioid-related overdoses.
TBRHSC recently reported it was seeing a 67 per cent increase in the number of patients coming to the Emergency Department with opioid overdoses compared with last year.
Under the pilot program announced by the hospital Tuesday, doctors at TBRHSC are now using opioid "digital order sets" to guide their decisions in the management of patients' pain.
Also known as clinical order sets, the hospital describes these as checklists which provide standardized guidance for acute pain management for various post-operative scenarios.
"Controlling and decreasing pain leads to better post-surgery outcomes, improved patient experiences, and reduced opioid prescribing rates," the TBRHSC announcement stated.
Hospital Chief of Staff Dr. Gordon Porter said digital order sets can cut the use of opioids because they include "very specific evidence-based recommendations.and considerations...These guide decisions for pain management so that there is either a reduced need to prescribe medication, pain medication can be weaker doses, and those medications may be required for shorter periods of time."
According to Health Quality Ontario, across the province more people are being prescribed stronger opioids. "For example," the TBRHSC announcement noted, "the number of patients who filled a prescription for hydromorphone—which is about five times stronger than morphine—increased by nearly 30% over three years."
Over the next three months, an Acute Pain Service Team at the hospital will pilot the use of the digital order set before it is rolled out to other areas across the hospital.
Their feedback will also be used in the development of a larger Ontario-wide strategy.
Experts from TBRHSC were among a group that collaborated in the development of an order set which the hospital says "addresses appropriate opioid prescribing, tapering and discontinuation for adults."
The consultations involved members of Ontario's Digital Quality-Based Procedures Program, the private-sector digital health company Think Research, Health Quality Ontario, the North West LHIN and 20 clinical leaders in the region from the acute, primary, community and mental health fields.
