Never Underestimate the Importance of Readiness
Joe Marks, Executive Director of Burke Recovery, explained that physicians on the Burke Substance Abuse Network were the impetus for the creation of the alert system. CHS Blue Ridge physicians were among the founding members of the BSAN—and eventually, the RxEAP task force—and came to the table because they were alarmed by the number of babies born in withdrawal from opioids they were seeing in their exam rooms, as well as opioid-seeking patients. Many also reported knowing colleagues who were overprescribing opioids. “The doctors came to the table knowing that they had been part of the problem and now wanted to be part of the solution,” Marks remembers. “The perfect storm was there: we had people who really wanted to do something about this problem, they wanted to form a task force, and the funding [PFS] was there to help us coordinate the effort.”
Build on Existing Connections
Two of the RxEAP task force’s most dedicated members are CHS Blue Ridge hospital physicians. Their support of the prescriber alert project and integral role in its development helped the task force forge critical connections with other key hospital administrators, including the hospital’s vice president of nursing. With her strong backing, the task force was able to connect with every nursing director, continuing education director, and practice manager in the health system. According to Sarah Dergins, a prevention specialist with Burke Recovery, “Relationships have been our biggest foot in the door.”
Think Strategically about Implementation
The RxEAP task force had concrete reasons for limiting the alert program to just the CHS Blue Ridge system. First, most physician practices in Burke County operated under the umbrella of CHS Blue Ridge. The CHS Blue Ridge system also used electronic health records, unlike some of the smaller physician practices in Burke County, which used paper records. Using an existing electronic record system that served 38 clinics meant that the RxEAP’s prescriber alert could reach a large number of physicians with one programmatic change in the system.
Don’t Operate in Isolation
One of RxEAP’s greatest strengths is that it functions as part of the larger BSAN coalition. As such, BSAN members are frequently tapped to grow the alert program and find new ways to decrease non-medical use of prescription drugs. “We strategically use BSAN meetings to identify and address gaps—in both our services and in our capacity to provide those services,” says Marks. “We are continually in ‘capacity-building’ mode.” For example, at one point Marks realized that the RxEAP task force lacked representation from the dental/oral surgery fields—two specialties that frequently prescribe opioids as part of care. When Marks mentioned this gap at a BSAN meeting, two BSAN members immediately stepped forward to join the task force.
Leverage Early Successes
Successful implementation of the prescriber alert system brought much-needed visibility to the BSAN’s other prevention activities. It also laid the groundwork for other interventions, such as the coalition’s “Lock Your Meds” communication campaign, comprising billboards, newspaper spots, and information cards for local pharmacies. In 2016, BSAN also distributed 139 medication lock boxes in “at-risk” homes throughout Burke County—homes with unlocked, controlled medications and children in residence.
Get Things Done
Both Dergins and Marks recognized the importance of moving BSAN, and eventually the RxEAP task force, beyond networking into action. Since the inception of the BSAN in 2011, every project they have taken on, from substance misuse awareness campaigns to the prescriber alert system, has been completed successfully. “They are not a group that sits around and talks about their problems every month and nothing happens,” says Dr. Melinda Pankratz, SPF-PFS State Grant Coordinator at the North Carolina Department of Health and Human Services, “They are very action-oriented. I think that helps keep people at the table.” Being solution-focused has helped both the BSAN and RxEAP develop new partnerships and forge new directions.