Duke Family Medicine Center is making a concerted effort to reduce the risk of opioid use in our patients. Over the past few years our providers have acknowledged that we all have to change the way we practice in order to reduce harm from opioids. Now, we are approaching this as a team effort to improve care and hold each other mutually accountable to meet new standards.
All of our patients taking daily opioids have been identified and placed in a quality improvement audit. On a monthly basis a small group of our providers meet to discuss patient cases that we have individually reviewed.
We discuss whether the care provided meets current standards as we interpret them from medical literature and our pain specialist colleagues. Feedback from this confidential review is returned to the providers caring for the patients we discuss. We are starting to rotate all of our providers into this process to learn from it and have a better appreciation for the results.
Personally this is the first time in primary care that I have worked regularly with other physicians and advanced practice providers to audit each other’s care and combine our expertise to provide better care for our patients. This happens regularly in an informal manner in day-to-day interactions in clinic, but this formal process has been a distinct change.
As a physician, I am giving up some of my autonomy and in return I gain more clinical knowledge and a support system that makes me more confident in my care. Most importantly, I truly believe that our patients are safer.
Earlier this year I joined our leadership team at the Duke Family Medicine Center as an assistant medical director. My main focus is managing the quality improvement activities of the clinic. I look forward to continuing our work on opioid safety and potentially using this model to improve other challenges in patient care.
Lorraine Sease is an assistant medical director of Duke Family Medicine Center. Email lorraine.sease@duke.edu with questions.
Editor’s note: A member of the Duke Family Medicine Center leadership team guest blogs every month.