Award-winning ASC demonstrates simple pain management strategy that reduces costs, length of stay
CSA Surgical Center, LLC in Columbia, MO is the recipient of the 2018–19 Bernard A. Kershner Surgical/Procedural Care Award from the Accreditation Association for the Ambulatory Health Care (AAAHC). The surgical center received the honor for a quality improvement program it implemented based on a study they conducted to improve the immediate post-operative pain management of laparoscopic cholecystectomy patients. The CSA’s poster “Post-Operative Pain Reduction Quality Improvement Study,” shows that by administering cost-effective per oral (PO) acetaminophen to patients pre-operatively, post-operative pain management and reductions in length of stay in the recovery room improved.
Narcotic usage also went down measurably. During the 6-month period prior to implementation almost 7 percent of surgical patients required zero narcotic pain medication in PACU. Improvement continued to grow after adopting the protocol with nearly 22 percent of patients needing no post-op narcotic pain killers within a 6-month timeframe. CSA now uses the PO acetaminophen protocol for several other procedures as well.
According to the poster, CSA says it launched the study in 2007 based on previous literature that claimed PO acetaminophen intervention reduces post-operative pain and improves outcomes for laparoscopic cholecystectomy patients, a population that can be challenging to care for because they typically require help managing pain and nausea.
The administration of acetaminophen preoperatively eliminated the need for any patient to receive three different IV narcotics in PACU (a decrease of more than 7 percent). CSA said the same results were obtained during the re-measure phase of the study. Additionally, less than 1 percent of patients required an extended length of stay due to pain (26 percent improvement over baseline).
All patients undergoing laparoscopic cholecystectomy at CSA, unless contraindicated, now receive 1000mg PO acetaminophen preoperatively per surgeon pre-op order.
