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How University of Virginia cuts opioid use by 74% with surgery recovery program

Enhanced Recovery After Surgery, which focused on just one type of operation, saved more than $1.3 million while freeing up over two-dozen beds.

Jeff Lagasse, Associate Editor

The University of Virginia Health System developed and implemented a special recovery program for thoracic surgery patients is getting them home sooner while decreasing both healthcare costs and opioid use.

According to a review of the program's first year, in fact, UVA reduced the use of morphine equivalents by 74 percent for one group of patients and 59 percent for another -- without compromising patients' evaluation of pain levels.

Importantly, it also reduced the median length of hospital stay among chest surgery patients by two full days, and saved more than $1.3 million while freeing up beds for about 28 additional patients.

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UVA launched its thoracic Enhanced Recovery After Surgery, or ERAS, program in early 2016, enrolling 139 patients in its first year. To evaluate its success, program organizers compared patients' outcomes and experiences to those of more than 220 previous patients who were not enrolled in the recovery program.

The benefits occurred without increasing the rates of surgical complications or hospital readmission. In fact, the program's organizers hope that it will eventually reduce readmission rates -- which would be a further financial boon for hospitals, as the Centers for Medicare and Medicaid Services levies financial penalties against facilities that underperform in this area.

ERAS is based on standardizing care for thoracic surgical patients through preoperative patient preparation, optimizing nutrition, avoiding excessive intravenous fluids and aggressively preventing pain. The pain prevention was achieved through a new combination of medications that dramatically reduced patients, reliance on addictive opioids, which researchers touted as an important step in addressing the country's ongoing opioid crisis.

The thoracic ERAS program is one of several surgical recovery programs UVA has implemented. It was originally introduced as a trial for patients undergoing elective colorectal surgery, but proved so effective that UVA quickly broadened it to other areas, including gynecologic and orthopedic surgery.

The researchers plan to continue to evaluate and improve the program by further monitoring patient outcomes and outpatient opioid use, among other factors.

Twitter: @JELagasse
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