RLANRCRancho Los Amigos National Rehabilitation Center
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We created focus groups using already established, outpatient-run channels such as the Patient Advisory Counsel and support groups in RLANRC's Wellness Center.
We reached our goals with a 56 percent decrease in the percentage of SCI inpatients on more than 30 mg/d of oral-morphine analgesic-equivalents on the JPI third floor (Figure (a)), and a 35 percent decrease in the percentage of polypharmacy (>10 routine medications) for all RLANRC SCI inpatients (Figure (b)).
The University of Southern California (USC) Lifestyle Redesign[R] [10] Pain Management Program has been adapted by a clinical specialist in RLANRC's Occupational Therapy Department to help transition our more challenging inpatients to RLANRC's outpatient clinics.
It is our observation that this lifestyle program makes a very big contribution and it is rather unique to RLANRC and USC.
Our ad hoc Pain Committee has successfully implemented the first iteration of hospital-wide changes geared toward reducing the use of opioids at RLANRC. Our measured outcomes and anecdotal observations illustrate the effectiveness of opioid tapering in a rehabilitation hospital using educational methods alone, without coercion of prescribers or patients.