Opioid Stewardship: Interprofessional Acute Care Models

ABSTRACT Opioids are classified as high‐alert medications by the Institute for Safe Medication Practices due to their potential for significant harm when misused. To address these risks, our institution established an interprofessional pain consult team in 2016. In 2017, pain pharmacists developed an opioid stewardship service which aligned with the 2018 Joint Commission pain management standards focusing on oversedation, safe prescribing, high‐risk patients, and quality improvement. By 2023, both services expanded across multiple hospitals, adapting to site‐specific needs. Following a 2019 merger which expanded our health system to 12 acute‐care hospitals and one long‐term acute care hospital across four regions (North, East, South, and Central), we leveraged telehealth in 2020 to enable remote pain consults by providers and pharmacists. Our interprofessional model includes three dedicated pain management pharmacists and five dedicated pain management providers conducting daily consultations, opioid stewardship reviews, quality improvement initiatives, and site‐specific education. Collaborating closely with hospitalists, specialists, and surgical teams, treatment recommendations are communicated directly to primary teams. Outcomes tracked via the electronic health record include relative value units billed, the number and types of interventions, provider acceptance rates, and preventable naloxone events analyzed using descriptive statistics. Our adaptable, interprofessional pain program model used the Interprofessional Education Collaborative (IPEC) competencies to address opioid safety through tailored local practices, role‐defined collaboration, and integrated communication. By aligning values, ethics, and teamwork, we achieved data‐driven improvements, including reduced intravenous (IV) opioid use, naloxone events, and high provider acceptance. Improvements are driven by, but not limited to, opioid stewardship, education, pain consults, orderset enhancements, policy updates, prescriber compliance, and adherence to evidence‐based practices. Annual goals are tailored to patient outcomes and site‐specific needs. The interprofessional pain management team has enhanced patient safety and care quality through targeted opioid interventions and consultative support.