Improving pain management and safe opioid use after surgery: A DMAIC-based quality intervention.

Background: Multimodal perioperative patient education and expectation-setting can reduce post-operative opioid use while maintaining pain control and satisfaction. As part of a quality-improvement project, we developed a standardized model for perioperative education built upon the American College of Surgeons (ACS) Safe and Effective Pain Control After Surgery (SEPCAS) brochure to improve perioperative education regarding opioid use and pain control.

Material And Methods: Our study was designed within the Define, Measure, Analyze, Improve, Control (DMAIC) quality-improvement framework.

Use of post-discharge opioid consumption patterns as a tool for evaluating opioid prescribing guidelines.

Background: Leftover pills from postoperative opioid prescriptions place patients and members of their communities at risk for opioid misuse. We aimed to better understand patients' post-discharge opioid consumption patterns to inform new methods of postoperative opioid prescribing.

Methods: We assessed post-discharge opioid consumption of general surgery patients and assessed the adequacy of discharge opioid prescriptions.

Decreased continuity in a residency clinic: a consequence of open access scheduling.

Background And Objectives: Open access scheduling decreases waiting time to see physicians by using same-day appointment scheduling. In primary care residency training, continuity of care may be difficult to preserve with this method of scheduling because requirements for rotations often results in residents being unavailable in their primary clinic practice. Our objective was to examine continuity of care in a family medicine residency clinic during a 1-year period prior to implementation of open-access scheduling and during a 1-year period after open access scheduling started.

Trends in off-label beta-blocker use: a secondary data analysis.

Background: The off-label use of beta-blockers might be prevalent, but no studies have provided empiric data on the off-label use based on utilization data.

Objective: This secondary data analysis was conducted to describe the trends of off-label use of beta-blockers among ambulatory visits made to office-based physicians in the United States.

Methods: Data from the National Ambulatory Medical Care Surveys from 1999 to 2002 were used in this study.

Childhood pesticide exposures on the Texas-Mexico border: clinical manifestations and poison center use.

Objectives: The purpose of this study was to describe differences in childhood pesticide exposures between counties on the Texas-Mexico border and nonborder counties.

Method: The authors reviewed all pesticide exposures among children younger than 6 years reported to the South Texas Poison Center during 1997 through 2000.

Results: Nonborder counties had twice the reported exposure rate of border counties.