The safe use of opioids begins when a patient is prescribed an opioid – no matter what the route of administration – IV, oral, intramuscular, transdermal, etc. The decision to prescribe an opioid is made by the attending physician in the best interests of the patient. This decision should be made taking into consideration both opioid and non-opioid alternatives with the goal of making sure that the patient does not suffer an adverse event, such as respiratory depression or addiction.

The Physician-Patient Alliance for Health & Safety (PPAHS has been at the forefront of building awareness of the benefits of continuous monitoring of patients, particularly when receiving opioids. We believe that continuous monitoring of patients – like the canary in the mine shaft – is an indicator of patient deterioration, such as opioid-induced respiratory depression, acute hypoxemic respiratory failure, or postoperative respiratory failure  – such events signal a need for intervention by clinicians in the patient’s treatment, which may prevent a serious adverse event or death from occurring.

To raise awareness about the value of continuous patient monitoring, PPAHS has engaged in countless initiatives and activities, including:

• Promotion of Best Medical Practices:
  • Development of the PCA Safety Checklist regarding use of patient-controlled analgesia.
  • Position Statements:
    • The need for continuous monitoring of patients receiving opioids.
    • The dangers associated with the concomitant use of benzodiazepines and opioids.
    • Precautions that should be taken when patients undergo procedural sedation.

• Speaking Engagements: Speaking to students at the invitation of University of Notre Dame, as well as presenting at and participated in conferences and webinars, including:
  • Crittenden Medical Conference 2012
  • The Eleventh National Quality Colloquium
  • Institute for Healthcare Improvement (IHI) 24th Annual National Forum on Quality Improvement in Health Care
  • 60th Congress of the Association of Perioperative Registered Nurses (AORN)
  • Premier Safety Institute webinar “Reducing ADEs and Harm Associated with Opioids: Safer Post-Operative Pain Management”
  • California Hospital Engagement Network webinar “Preventing Opioid-Related Adverse Events: Patient Stories and Best Practices”
  • Northern Regional Respiratory Care Conference

• Being a Media Resource: PPAHS has received frequent media requests to comment, answer questions and or to submit articles by many media outlets including:
  • ABC News
  • Becker’s Hospital Review
  • CBS News
  • Hospitalist News
  • Internal Medicine News
  • Los Angeles Times
  • Outpatient Surgery
  • Patient Safety & Quality Healthcare
  • Project Health Radio
  • SurgiStrategies
  • UK Daily Mail
  • USA Today

• Helping to Maintain Patient Access and Safety: Commented on and initiated discussion about patient access and safety issues, including:
  • FDA’s oversight role
  • CMS’s patient monitoring proposal

• Illustrating Clinical Examples: best practices illustrated by health care expert studies and examples, such as how:
  • U.S. Department of Veterans Affairs believes it can prevent more than 60 percent of adverse events related to patient-controlled analgesia pumps.
  • St. Joseph’s/Candler Hospitals in Savannah, Georgia, has not only had eight years of event-free use of PCA using “smart” PCA pumps with integrated capnography monitoring, but calculated that their decision made great financial sense: (a) $4 million — estimated potential expenses averted (not including potential litigation costs); and (b) $2.5 million — 5-year return on investment.
  • Wesley Medical Center in Wichita, Kansas, for RT Magazine’s “Best of 2013 Respiratory Care Award” for bringing the percentage of moderate and severe patient-controlled analgesia adverse events progressing to code blue 13 percent to zero percent.

• Highlight Patient Tragedies: Assisting and working with families that have lost loved ones to opioid-induced respiratory depression, including:
  • A Promise to Amanda Foundation
  • Leah’s Legacy