At Ellenville Regional Hospital, a small percentage of patients (“super utilizers”) relied excessively on the hospital’s emergency department (ED) for chronic pain relief. In response, they initiated a community-wide Opiate Reduction Medicaid Accelerated eXchange (MAX) Series project with The Institute for Family Health.
A group of 64 patients was identified who met the following criteria: chronic pain diagnosis and five or more visits to the ED with treatment of chronic pain by opioids. The project team developed a chronic pain policy with new ED treatment protocols using non-addictive pain medications and a care navigator who assists patients with accessing primary care or other health services.
Within a year of implementation, visits to the hospital’s ED by super utilizers decreased by 48.6%. Similarly, administration of opioids to super utilizers of the ED for chronic pain decreased by 63.6% decline. In general, opioids administered to patients presenting to the ED (excluding the super utilizer group) also showed a decrease in administration by 42.5%.