IHA Daily Briefing: April 11

Wednesday, April 11, 2018

IHA Releases Opioid Guidelines for Prescribers
CDC Issues Alert on Synthetic Cannabinoids
Don't Delay, RSVP for Next Week's Hospital Advocacy Day
Briefly Noted

IHA Releases Opioid Guidelines for Prescribers
To address Illinois' opioid epidemic, IHA led a collaborative effort to develop Opioid Prescribing Guidelines: For Patients in the Emergency Department and Immediate Care Centers. The guidelines are meant to assist clinicians in treating patients with acute and chronic pain in the emergency department.

Leaders from IHA's Institute for Innovations in Care and Quality worked closely with leaders from the Illinois College of Emergency Physicians (ICEP) to create both long and short versions of the guidelines. We encourage hospital leaders—particularly physician and nursing leaders—to discuss and incorporate these guidelines into daily patient care.

Both versions refer to three common ED scenarios:

  • Prescribing for opioid-naïve individuals with acute injuries;
  • Exacerbation of chronic pain in patients receiving long-term opioid therapy; and
  • Co-prescribing of naloxone and referral to medication-assisted treatment for patients at risk of overdose or with opioid use disorder.

IHA and ICEP leaders aligned the guidelines with those of the Centers for Disease Control and Prevention, American College of Emergency Physicians, American Academy of Emergency Medicine and The Joint Commission.

The guidelines were initiated at the request of IHA's Medical Executive Forum, a group of about 30 physician leaders across the state, in April 2017. Developing strategies and convening stakeholders to deal with the opioid crisis is also a 2018 IHA strategic priority—identified by hospital and health system leaders.

CDC Issues Alert on Synthetic Cannabinoids
The Centers for Disease Control and Prevention (CDC) has released an outbreak alert on Vitamin K-Dependent Antagonist Coagulopathy Associated With Synthetic Cannabinoids Use. Illinois has seen a surge in emergency room patients presenting with coagulopathy (excessive bleeding) related to synthetic cannabinoids use. It is suspected that a variety of synthetic cannabinoids are tainted with brodifacoum, a chemical commonly used in rat poison. The CDC alert provides information on issues related to clinical signs of coagulopathy and healthcare provider guidance.

As of April 10, the Illinois Dept. of Public Health (IDPH) has received reports of 118 cases, including three deaths, linked to an outbreak since March 7. These cases have reported using synthetic cannabinoid products before suffering from severe bleeding.  More details can be found on IDPH’s synthetic cannabinoids webpage.

Don't Delay, RSPV for Next Week's Hospital Advocacy Day
Next week, IHA will hold a special Hospital Advocacy Day in Springfield on Wednesday, April 18. Meet face-to-face with your legislators while the Illinois General Assembly is focusing on the state budget, Medicaid and other critical issues for hospitals.

Strong IHA member participation is critical to the success of this event. Please RSVP ASAP so IHA can arrange meetings with your legislators. For scheduling purposes, please indicate in the RSVP form which state legislators you would like to meet with and the order of your preference.

For more information, see IHA’s memo.

Briefly Noted
The Substance Abuse and Mental Health Services Administration recently launched the Evidence-Based Practices Resource Center, which aims to provide communities, clinicians, policymakers, and others with information and tools to incorporate evidence-based practices into their communities and clinical settings. The center is searchable and allows providers to identify resources or best practices by topic area, target audience (e.g., clinicians, patients), populations (e.g., pregnant women, youth, people in the criminal justice system), and resource type. The agency plans to use the center to disseminate materials that incorporate the latest scientific evidence on mental health and substance use, including Treatment Improvement Protocols, toolkits, resource guides, and clinical practice guidelines.

Using 2011–2016 National Health Interview Survey data, a recent Morbidity and Mortality Weekly Report estimated that out of 160.7 million working adults, 6.8 percent currently had asthma. Among those, 44.7 percent experienced an asthma attack, and 9.9 percent had an asthma-related emergency department visit in the previous year. The current asthma prevalence was found to be highest among workers employed in the healthcare and social assistance industry (8.8 percent) and in healthcare support occupations (8.8 percent). According to the report, previous research has found that new-onset work-related asthma in these workers has been associated with exposure to cleaning and disinfecting products, powdered latex gloves and aerosolized medications.

The Centers for Disease Control and Prevention (CDC) released its final report on a salmonella outbreak earlier this year that hit eight states, including Illinois, sickening 265 people and leading to one death. Deli chicken salad from Triple T Specialty Meats, Inc., sold in Fareway grocery stores from Jan. 4 to Feb. 9, was the confirmed product contaminated with an outbreak strain of Salmonella Typhimurium. The product was recalled on Feb. 21. While the outbreak appears to be over, consumers who may have this product frozen for later use are asked to throw it away or return it to the place of purchase.