Norwalk Hospital Emergency Department Opioid Initiative Reduces Physician Ordering By 45% through a New Pain Management Program

Danbury Hospital
Norwalk Hospital Emergency Department

Western Connecticut Health Network (WCHN) continues to commit resources to those suffering from mental health and substance abuse issues across the continuum of care. Of note is a new and innovative pain management program at Norwalk Hospital designed to reduce opioid ordering by physicians in the Bauer Emergency Care Center. We believe this is the first program of its kind in the state of Connecticut.

Program Focus

  • Adoption of new guidelines and protocols
  • Implementation of improved ultrasound guided peripheral nerve blocks, thus decreasing the need for narcotics in the Emergency Department (ED)
  • Use of utilization data to monitor the monthly usage of opiates in the ED and measure progress
  • Extensive education for providers on the opioid issue, opportunity for improvements, and the use of innovative alternate pain management therapies, including the use of non-opiates to alleviate pain

Outcome of the Program
The outcome realized at Norwalk Hospital was a 45% reduction in opioid ordering in the first year (2016 to 2017), which is a substantially better outcome than comparative national data reflects.

Connecticut suffers from a well-documented opioid abuse issue. It has been building for some time but hit crisis proportions in recent years. The state saw a steady increase in use and abuse with drug-related deaths increasing 25.6% from 2014 to 2015 and an additional rise of 24% from 2015 to 2016. In 2017, the number of deaths appeared to stabilize. However, new data from the Connecticut Department of Public Health is reporting a suspected 1,317 drug-related ED visits statewide in the first two months of 2018.

More State of Connecticut date is available here.

More Information
WCHN is implementing additional strategies to address unmet mental health needs include:

  • All providers in Connecticut are adopting new state-wide controlled substance guidelines including allied health professionals. The new guidelines educate the medical staff and our patients about when and how addiction problems occur and will steer providers toward best prescribing practices when administering controlled substances in our offices, hospitals, and EDs.
  • WCHN has added SBIRT screening (Screening, Brief Intervention, and Referral to Treatment) for substance use disorders in addition to questions about housing, transportation, and access to nutritious food in order to best identify and treat at-risk patients and those with addiction problems. SBIRT is an evidence-based practice used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs.
  • Collaborative Community Care Teams offer intensive case management for patients that are high hospital utilizers who are homeless or housing at-risk. Outcomes include sobriety, stable housing, and employment.
  • Mental health telemedicine and crisis counseling in the more rural New Milford Hospital community reduces the need for transfer to out of community hospitalization.
  • WCHN is implementing screening and Recovery Coaches in all hospital EDs.
  • Community-wide NARCAN education and distribution initiative are ongoing.Extensive substance use and abuse medical and nursing education remains a network-wide commitment.

To learn more and speak with leaders of the Norwalk Hospital ED opioid initiative, please contact:

Andrea Rynn
Director, Public & Government Relations

Amy Forni
Manager, Public Relations