Methodist, who most often
place TAP blocks, inform anes-
thesia providers before surgery
that they'd placed the blocks
and that the OR team was
implementing a new pain man-
agement protocol that focused
on using fewer opioids during
surgery.
"We educated providers one by one before every case to review the
protocol and ensure they were onboard with the medications they
administered during surgery," says Dr. Haas. "We asked them to elimi-
nate or reduce opioid use in conjunction with the TAP block and
injection of local anesthesia."
Dr. Haas has tracked opioid use among colorectal surgery patients
since he implemented the new pain control pathway and has seen a
reduction in use throughout all phases of surgery. As important and
perhaps more interesting: The hospital's patient satisfaction scores —
no small measure thanks to HCAHPS incentives — have remained
constant, even as opioid use has waned.
The success of the program got the attention of the hospital's execu-
tives and departmental chairs. It now serves as the model that a newly
created quality improvement committee is implementing in each serv-
ice line throughout the health system. Dr. Rosas is in the process of
applying the protocols to complex spine procedures and has already
seen improvement among patients with respect to less opioid use,
faster post-op ambulation and less pain. "If it can be done in big spine
cases," he says, "it can be done in most any procedure."
What's next? "Our goal is painless colectomy," says Dr. Haas. "We
D E C E M B E R 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 6 3
"The idea is to trick the body into
thinking surgery didn't happen,"
— Alejandro Rosas, MD
