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SLV Health Participates in the Colorado ALTO Project with Aim of Reducing Opioid Administration in Emergency Departments

Dr. Sam Slade and Monica Hindes, RN, consult with a patient at the SLVH Regional Medical Center Emergency Department.

Alamosa, La Jara, Colorado. San Luis Valley Health is participating in the Colorado alternatives to opioids (ALTOs) Project as part of the Hospital Transformation Program to reduce the administration of opioids in our hospitals’ emergency departments (ED). SLV Health’s goal is to improve pain management for its patients and return them to a maximum quality of life while also recognizing and controlling the inherent risks of prescribing highly addictive medications like opioids. SLV Health’s clinicians are dedicated to understanding and responding appropriately to patients’ physical and emotional symptoms of pain in addition to taking steps to help the community combat the ongoing opioid epidemic.  This project includes both the Regional Medical Center in Alamosa and Conejos County Hospital in La Jara.

This initiative implements components from the 2017 Opioid Prescribing & Treatment Guidelines developed by the Colorado chapter of the American College of Emergency Physicians (ACEP) in both of SLV Health’s emergency departments. These guidelines include using alternatives to opioids as a first line of defense in treating patients with painful conditions before using opioids.

“When patients come to us in pain, we want to make them comfortable without adding to their distress. By participating in the ALTO program, we have more options to help our patients than we have in the past. Our clinicians assess each patient at each visit and utilize the most appropriate medications for each patient’s condition. That sometimes includes using non-opioid medications first, before deciding to use opioids for pain,” Margaret White, Director of Quality and Safety at San Luis Valley Health.

Colorado is at the forefront of the nation’s opioid epidemic with the 12th highest rate of prescription opioid misuse and abuse out of all 50 states. Colorado hospitals, particularly the EDs, are in a strong position to integrate new and more effective pain management treatments that are tailored to each patient’s unique pain experience.

The Colorado Hospital Transformation Program (HTP) was designed to increase and improve transitions of care. The ED ALTO measure is one of the measures that SLVH selected as it is imperative for our community and consumers to participate in the statewide effort to reduce opioid use and abuse. Our goal through HTP is to reduce opioids and increase ALTO’s (alternatives to opioids). We are being measured on the number of opioids and ALTO’s given to patients in the ED (emergency department). This care redesign around decreasing opioids and increasing ALTO’s will improve patient outcomes, help SLVH expand relationships with our community partners, and provide better care to our patients.  

In January 2018, Colorado Hospital Association announced the results of the Colorado Opioid Safety Pilot initiated in 10 EDs across the state in 2017. During the six-month pilot, the participating facilities, which included the SLVH RMC ED, reduced the administration of opioids by an average of 36 percent and increased the usage of ALTOs by 31 percent.