Hospital Spotlight: Kalkaska Memorial Shines a Light on Opioids
Posted on December 05, 2019
Every year, half of all Americans over the age of 18 will develop a musculoskeletal injury that will persist for more than three months. Due to the persistence of pain in the afflicted areas, providers are frequently faced with a choice on whether to prescribe opioids for pain management. Over the past decade, research has validated that the treatment of pain often requires an integrated approach due to many variables that contribute to a patient’s perception of their pain and their response to the treatment. The Kalkaska Memorial Health Center team has done just that through its innovative use of specialized treatment.
To reduce opioid prescriptions to patients experiencing pain, Daniel Conklin, DPT, vice-president of ambulatory services, worked with other hospital administrators and providers to implement a specialized approach to treating pain. An on-call position was created to screen patients presenting to the emergency department or family medicine due to pain. Once patients are cleared of alternative conditions by the provider, the dedicated physical therapist (PT) can see the patient the same day and implement the McKenzie method, also known as mechanical diagnosis and therapy (MDT), for locating and treating pain.
The MDT is primarily used for treating pain in the spine and related extremities by using repeated movement exercises and other prevention measures. MDT heavily emphasizes the role of patient self-care following this visit, as most of the treatment comes from exercises prescribed by the PT. Seventy percent of patients presenting with pain can be categorized as mechanical, meaning that pain will increase or decrease based on changing the loading on the tissue.
The team at Kalkaska Memorial Health Center begins with exercises that require the least amount of force. Rather than instructing patients to perform four to five exercises when they return home, they are told to engage in one or two exercises, including one that solely focuses on improving posture to reduce symptoms. By limiting exercises between PT appointments, patient symptoms can be monitored with a clearer understanding of cause and effect. Ideally the exercises produce a centralizing effect on the symptoms. This can occur very rapidly, often times within 5-10 minutes, which reduces pain and the need for prescription of opioids. Ultimately, most patients leave with reduced pain, a clear at-home plan and over-the-counter medication recommendations only.
While MDT has not produced quantifiable results in the time taken to treat pain, its implementation has significantly reduced opioid prescriptions for treating pain. In addition to the reduction of prescribed opioids, Kalkaska Memorial Health Center’s on-call PT initiative is budget neutral for the hospital and saves cost and time for patients. Looking ahead, the team expects to increase its daily on-call hours to treat pain as holistically as possible.
This article was featured in the MHA Keystone Center Newsletter. To subscribe, please contact the MHA Keystone Center.
Posted in: Member News, Patient Safety & Quality