2018 2nd Quarter Update - PORH...Apr 02, 2019  · Health Promotions Specialist. Lancaster General...

Rosemary Search, RN BSNHealth Promotions SpecialistLancaster General Health/Penn Medicine

Christine GloverCommunity Prevention MobilizerCompass Mark

www.LancasterJoiningForces.org

Pennsylvania Public and Community Health Conference

April 2, 2019

Objectives

• Recognize the use of evidence-based practices to address opioid addiction across systems

• Describe the importance of goal setting and data collection and analysis to achieve measurable outcomes

• Identify appropriate community partners to implement a county wide public health approach

2

Substance Abuse/MisuseFramework for Action

Continuum of Care

3Source: SAMHSA

4

Guidelines for Prescribing Opioids for Pain

• Determining when to initiate or continue opioids for chronic pain

• Opioid selection, dosage, duration, follow-up, and discontinuation

• Assessing risk and addressing harms of opioid use

Goal Setting

5

Strategic Plan

6

7

Saturate the Community with Unified Messaging

Over 102,000 Distributed

8

Website Launched

www.lancasterjoiningforces.org

9

50171-Manheim Pike

10

11

Strengthening Efforts

• ED Warm Hand-off

• Naloxone Access

• Prescription Drug Take-Back

• Promotion of evidence-based school prevention programs

• Increased access to treatment and recovery services

12

www.opioidaware.org

Improving Patient Safety

13

Improve Data Collection and Public Reporting

• Improved timely reporting on outcomes (overdose deaths)

• Process measures tracked and shared at steering committee and public meetings (example below)

14

15

Strengthen efforts

Evaluation and

reporting

Improve patient safety

Saturate the community

Next 12 months

Data Collection and Analysis

16

Total Overdose Deaths, Lancaster County2014-present (as of 3/1/2019)

Sources: Pennsylvania State Coroners Association Report on Overdose Death Statistics, 2014Analysis of Drug Related Overdose Deaths in Pennsylvania, 2015. Prepared by the DEA Philadelphia Field DivisionAnalysis of Overdose Deaths in Pennsylvania, 2016. Prepared by the DEA Philadelphia Division and the University of Pittsburgh.Lancaster County Coroners Office

6080

117

168

108

130

20

40

60

80

100

120

140

160

180

2014 2015 2016 2017 2018 2019

Num

ber

of D

eath

s

17

2018 Overdose Deaths in Lancaster:A Closer Look

Source: Lancaster County Coroner’s Office

18

Unknown4%

20-2925%

30-3929%

40-4925%

50-5917%

Female22%

Male74%

Unknown4%

SexAge

PDMP Opioid Dispensing Rate

0

50

100

150

200

250

2016 Q3 2016 Q4 2017 Q1 2017 Q2 2017 Q3 2017 Q4 2018 Q1 2018 Q2

Opioid Dispensing Rate Per 1,000 Residents

Lancaster County Pennsylvania

Source: PA Prescription Drug Monitoring Program, Interactive Data Report

86,992total

dispensed66,850total

dispensed

19

PDMP Risky Prescribing Measures

Source: PA Prescription Drug Monitoring Program, Interactive Data Report

0

1

2

3

4

5

6

7

8

9

2016 Q3 2016 Q4 2017 Q1 2017 Q2 2017 Q3 2017 Q4 2018 Q1 2018 Q2

Rate of Individuals Per 1,000 Residents with Average Daily MME >90

Lancaster County Pennsylvania

3,869individuals

2,972 individuals

Narcan Administration Trends, 2017-2018

134 127

179

122

78

247

148

102

21 29

31

29

49

89

75

44

5

8

8

0

50

100

150

200

250

300

350

400

2017 Q1 2017 Q2 2017 Q3 2017 Q4 2018 Q1 2018 Q2 2018 Q3 2018 Q4

Num

ber

of In

cide

nts

Narcan Administration by First Responders

Narcan Administered by EMS Narcan Administered by Law Enforcement

Narcan Administered by Fire Department Total Overdose Deaths per Quarter 21

2018 Trends

• Overdose Deaths

• Narcan usage by first responders

• Risky Prescribing Behaviors

• Opioids Dispensed

22

23

How have we organized for

change?

Steering Committee

Community Groups

26

LancasterJoiningForces.org

Thank You