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Geisinger unveils ProvenRecovery program for surgery patients which cuts down on opioid use, speeds recovery

Pilot program showed an 18 percent drop in opioid use and cut length-of-stay in half for certain surgery patients, yielding big savings.

Beth Jones Sanborn, Managing Editor

Geisinger has announced a new "surgical redesign" program that seeks to speed up the healing process, improve pain management and cut down on opioid use.  Called ProvenRecovery, the program will be implemented across 42 surgical procedures impacting roughly 15,000 surgery cases annually. Geisinger said they hope to reach 100 surgical specialties by the end of 2019.

ProvenRecovery combines best practices gleaned from their ProvenCare program in cardiac, bariatric, spine and joint surgical care with industry best practices for elective surgeries.

The pilot program, which kicked off in June 2017, propelled an 18 percent drop in opioid usage across the organization, and hospital lengths-of-stay for neurosurgery and colorectal surgery patients was cut in half, saving the system $4,556 per case for colorectal surgery patients.

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The program focuses on proper nutrition, pain management especially avoiding opioids and promoting post-surgery mobility.

A pre-surgery consultation provides patients with a kit that includes care instructions, mobility instructions and immunonutrition drinks. In contrast to the traditional pre-surgery fasting, the drinks are formulated to get patients to a proper nutrition level before a surgery to help reduce infection, speed healing and "account for nutrition gaps in the average American diet," Geisinger said.

The program also seeks to avoid the use of opioids, and in many cases surgeries are opioid free. Pain is controlled by specifically targeting the surgical area, allowing for "effective pain control of just one area," and non-opioid medications is used, depending on the surgery, such as local anesthesia, acetaminophen, ibuprofen, gabapentin, ketamine and lidocaine.

Once in the recovery room and awake, patients are encouraged to move and are assisted with early mobility in and around the bed. This mobility helps to speed up the recovery process.

"In my 35 years in surgery, this is the innovation with the greatest potential to improve the patient experience, save lives, reduce complications and be less disruptive to patients," said physician Neil Martin, Geisinger's chief quality officer and chair of Geisinger's neuroscience institute. "With ProvenRecovery, we are empowering patients to be healthier before surgery, leading to fewer surgical complications and patients returning to their lives sooner."

"Since the early 90s, Geisinger has been pioneering patient-centric programs that revolutionize care design and management, paving the way for the industry in the move to value," said Jaewon Ryu, Geisinger's interim president and chief executive officer. "ProvenRecovery is a natural evolution of these efforts, building on the successes of our ProvenCare program. By getting patients healthier and out of the hospital sooner, not only are we improving lives, we're also reducing overall costs of care."

Twitter: @BethJSanborn
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