Despite rising opioid prescription and overdose rates, organizations haven't figured out the right way to respond. But it's not for a lack of trying: Planners have been seeking ways to address opioid misuse and using resources to do so.
So what's the problem? Health systems often fail to include other key stakeholders in the conversation—leading to disjointed, duplicative initiatives that are at odds with one another.
Intermountain Healthcare, a 22-hospital not-for-profit health system, has overcome this problem with its community-based strategy. Read on to learn more about Intermountain's approach.
Intermountain's collaborative approach
Intermountain partnered with the Utah Department of Health's Coalition for Opioid Overdose Prevention to implement the Opioid Community Collaborative. Through this program, Intermountain leaders work with several additional partners, including The University of Utah, Poison Control, local authorities, and not-for-profit organizations focused on substance abuse.
Their efforts are correcting patient attitudes and behaviors that lead to opioid misuse, such as poor prescription adherence and drug diversion (patients providing their prescription drugs to others). For instance, leaders saw rates of drug diversion decrease by 8% over the past 5 years, according to the results of an Intermountain community survey.
Three key lessons
Attaining these results hasn't been easy—but these three lessons helped Intermountain achieve success:
1. Identify what is, and is not, your expertise
Intermountain recognizes that each partner can bring something different to the table—which is why each partner owns responsibilities based its expertise and perspective. For example, Intermountain leads four initiatives: public awareness, provider education, patient education, and treatment access. Other approaches, such as data evaluation, criminal justice, and naloxone distribution, are owned by law enforcement and the Department of Health.
Key takeaway: Recognize and leverage each organization's strengths to delegate communitywide opioid reduction efforts effectively.
2. Understand local population dynamics to inform reduction efforts
The opioid crisis is rooted in more than just medicine—there are also many psychosocial factors at play. To identify these factors, Intermountain conducts annual surveys and focus groups. Intermountain cites these surveys and focus groups as essential to informing opioid mitigation efforts, as they can yield counterintuitive insights.
For example, local patients were confused by seemingly conflicting provider messages on prescription opioids and antibiotics: some messages stressed strict prescription adherence and the importance of "finishing the pill bottle," while others stressed using opioids "only as needed." That knowledge allowed Intermountain to improve its patient education efforts.
Key takeaway: Inform reduction efforts by diagnosing patient psychosocial influences that are unique to the opioid crisis in your patient population.
3. Track impact on provider and community opioid behaviors
As with any quality improvement campaign or initiative, tracking long-term outcomes and progress is essential. Intermountain's yearly surveys and focus groups do more than just inform strategy—they help track improvement. This creates a feedback loop to identify any existing gaps in provider and patient education and ensures that efforts are actually driving improvements. Intermountain has tracked significant progress in opioid-related behaviors in the community since the start of the program.
Key takeaway: Measure changes in patient attitudes and behaviors, as well as prescription rates, to track the impact of opioid mitigation efforts.
How to build the business case for community partnership
To be successful, population health programs must invest heavily in partnerships with local organizations and health departments.
Download our white paper to learn how to develop and leverage these partnerships to address the root causes of local health challenges. See page 12 for our complete community health initiatives metric pick list.