Naval Hospital Bands with Regional Health Care Agencies to Reduce Pain Medication Abuse

By Navy Capt. Lynn Welling, commanding officer, Naval Hospital Jacksonville, Fla.

Collaboration has long played a critical role at driving innovation and positive change around the world to enhance the way we live, learn and play. In health care, a big priority right now is banding together world leaders in the fight against non-communicable diseases such as cancer and diabetes, which have overtaken infectious disease as the world’s leading killers.

At Naval Hospital Jacksonville we understand the role collaboration has in helping people live the happiest and healthiest lives possible. In fact, we’ve had a long history of collaboration and have more than 100 training, research and support agreements with local, regional and national universities, colleges and medical organizations.

One way we hope to make a positive difference for our 215,000 beneficiaries and our 2,500 staff who care for them is through our partnership with the Northeast Florida public and private health care organizations involved in the Quality Collaborative of Northeast Florida — an initiative of the Global Center for Health and Medical Diplomacy at the University of North Florida.

Recently we have come together to address our regional problem involving the misuse of controlled substances. This abuse has reached epidemic levels in the U.S. and is especially prevalent in Florida. As a practicing emergency medicine physician, there are usually two or three people who come in to our emergency room (ER) every shift with what looks like drug-seeking behavior.

Earlier this year, I proposed to the members of Quality Collaborative that a set of guidelines be developed to ensure the appropriate treatment of chronic or recurrent pain throughout local emergency rooms, while reducing abuse of pain medication. The members of the group quickly embraced the idea. Together we developed the guidelines and on Sept. 14, we announced the regional implementation throughout 15 organizations in Northeast Florida. Naval Hospital Jacksonville, Fla., will be the first to roll out the guidelines in our ER on Oct. 1. Fourteen other organizations involved in our Quality Collaborative initiative — including Mayo Clinic, St. Vincent’s, Baptist Health and Shands Jacksonville — plan to enact the guidelines in the coming months.

While ERs like ours will continue to prescribe appropriate pain medications for acute pain, we’re not going to be a narcotics supplier. Our guidelines include discouraging the prescribing of narcotics for chronic pain, sharing information between hospitals to prevent doctor-shopping and refusing to replace lost or stolen prescriptions. We will also encourage that one doctor prescribe all of a patient’s controlled-substances.

Our guidelines comply with state law and complement recent state legislation, which includes a prescription drug-monitoring database to capture all dispensed controlled substances. Our efforts are ultimately aimed at placing our patients first by ensuring they get the most appropriate treatment for their pain. Individually and collectively, we are doing everything possible to provide the best possible experience and outcomes for each and every one of our patients — our nation’s heroes and their families.