University of California San Francisco

Elizabeth Lancaster, MD Winner of APDS Best Resident Paper Award at Surgical Education Week 2019

UCSF Resident Research Program
May 15, 2019

UCSF general surgery resident Elizabeth Lancaster, M.D. received the APDS (Association of Program Directors in Surgery) Best Resident Paper Award for presentation of her paper, Residents as Key Effectors of Change in Improving Opioid Prescribing Behavior, at Surgical Education Week 2019 in Chicago, IL.

With mentors Dr. Kenzo Hirose and Dr. Liza Wick, Dr. Lancaster developed a quality improvement program focused on improving post-operative analgesia prescribing patterns amongst general surgery residents. Her paper highlights the important role of residents in the quality improvement process and the power of educational interventions for changing behavior. 


Research Highlights

There is a national imperative to curb the flow of opioids into our communities.  In academic medical centers, the majority of discharge opioid prescriptions are written by residents who receive predominantly ad hoc, peer-to-peer education on perioperative analgesia. We aimed to reduce opioid overprescribing after common general surgical operations through a resident led quality improvement project that involved formal educational interventions and feedback on prescribing habits.
Results: After our educational intervention, residents’ impression of the appropriate number of opioid pills necessary after common general surgical operations decreased significantly, as measured by surveys pre- and post-intervention. Electronic health record data regarding actual opioid prescribing behavior shows significant discrepancy from the survey responses, but does show a significant decrease in the quantity of opioids prescribed for most evaluated operations following the educational intervention.
Conclusions: Opioid prescribing is an ideal target for resident led education and quality improvement. Residents’ attitudes towards appropriate opioid prescribing tends to differ from actual prescribing habits. Our results demonstrate that a well-scoped, resident-driven quality improvement program can lead to change in both attitudes and practice surrounding opioid prescribing.

Read Abstract

Tags:
Quality Improvement
Post-Operative Analgesia
Opioid Prescribing
Eras