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National Experts Explore Patient Safety Solutions and Duval County’s Opioid Crisis, Led by JU QSEN Institute

By Sheri Webber

Jacksonville University’s QSEN Institute Regional Center hosted its 2018 Patient Safety Forum on March 2, welcoming a sold-out crowd that included students, safety professionals, policymakers, compliance professionals, pharmacists, risk managers, and medical professionals from across the spectrum of the healthcare industry.

The Forum, planned and chaired by JU’s Dr. Teri Chenot and Dr. Roberta Christopher, was an opportunity for interdisciplinary healthcare professionals, students, faculty, and renowned experts to collaborate and learn more about patient safety.

During the full day of conferences, networking, and healthcare exhibitions, a wealth of emerging issues were explored, such as interprofessional simulation and training, emergency preparedness, patient safety testimonials, and much more. Most notable on the Forum’s agenda was the much-anticipated morning session, The Opioid Epidemic in Northeast Florida: Innovative Solutions. President Tim Cost, Councilmember Bill Gulliford, Dr. David Rice of Baptist Health, and stellar panelists Dr. Ashley Norse of UF Health Jacksonville, Dr. Raymond Pomm of River Region Human Services and Gateway Community Services, and Dr. Michael Sorna of North Florida-South Georgia Department of Veterans Affairs, led a discussion about the epidemic that claims approximately 14 lives a day in the state of Florida, and two in Duval County.

“Here at Jacksonville University, we make education integrated and applied, and it’s a pleasure to welcome these leaders who have stepped away from their responsibilities for a day to invest in our students.”  ~ Tim Cost, President

Gulliford, introduced by President Tim Cost as a friend to the University, is a staunch advocate for solutions to the crisis. “This is not a down-the-alley or behind-a-building type of issue,” he said. “We know that.” He expressed an urgency to finding both solutions and funding for those affected in Jacksonville.

In early January, Jacksonville City Council approved more than $200,000 in emergency funding to expand the Medical Examiner’s Office after learning that the office often lacked adequate space to store the bodies of overdose victims. The Jacksonville Medical Examiner’s Office processed approximately 200 cases of overdose deaths in 2015 and more than 460 in 2016. Statistics for 2017, not yet finalized, were said to be on track to double once again. The City of Jacksonville, Gulliford told Forum attendees, has now officially filed suit against pharmaceutical manufacturers and distributors connected to damages incurred by the opioid epidemic locally.

Expert panelists addressing the fully-engaged QSEN audience echoed Gulliford’s urgency.

“This is the HIV of this decade,” said Dr. Ashley Norse, Director of Operations at UF Health Jacksonville Department of Emergency Medicine. She attests to a sharp rise in overdose-related cases that began in 2010 and continues to climb. “The challenge becomes how to treat pain,” she said. Emergency room (ER) professionals deal with pain management in patients 24/7. Although many ER doctors and personnel are concerned about legislating the administration of specific drugs and what precedents are being set, Norse recognizes that attitudes about pain are shifting nationwide. Such paradigm shifts will soon reach the college classroom as a new generation of healthcare providers step into the workforce.

“Jacksonville University is so fortunate,” Gulliford said, referring to the University’s impressive growth in recent years, and to JU positioning itself to influence students choosing scientific, medical, and “first responder” areas of study.

Dr. Raymond Pomm, Vice President of Medical Services at River Region Human Services and Medical Director of Gateway Community Services, also participated as a panelist, sharing his experience with a new pilot program hosted inside the emergency facilities of St. Vincent’s Medical Center Riverside.

“The medical community should have had discussions about the opioid crisis in 1999,” said Pomm, who leads the program. It operates 4 days a week, 24 hours a day. Both Pomm and Gulliford expressed hope in seeing the program implemented at all Jacksonville area hospitals. The multifaceted process used by the program includes resuscitation/stabilization of the patient, immediate family education, patient education, recovery/withdrawal care and mental health care—all happening inside the emergency department and before a patient is transported to a detox facility. In addition to medical personnel, the program requires both a recovery care specialist and mental health specialist on the floor 24/4.

Pomm shared with QSEN participants that most emergency departments, locally and nationally, do not routinely test for fentanyl and other less-publicized substances. He says that coding and overdose treatment protocol varies widely from hospital to hospital, and that medical examiners typically run such tests only for victims linked to a crime or suspected crime. “Whatever number you hear, they’re actually way higher,” he told attendees. And according to Pomm, 100 percent of heroin overdose cases are also positive for fentanyl, which is why the pilot program utilizes what is currently the only lab in the U.S. to perform 10 different analogs per patient and on the spot.

“Drug dealers know they don’t need to shoot you to kill. All they have to do is give a little bit more of what you don’t know is in there,” Pomm told attendees. The need for comprehensive testing, he explained, is of great importance.

QSEN attendees were audibly impressed by early results from the program. Out of a total 45 patients, more than 30 agreed to enter detox, only 2 overdosed again, and zero patients were lost. Follow-up, he says, is key.

Recommended viewing according to QSEN presenters– “Chasing Zero: Winning the War on Healthcare Harm

The correlation between mental health issues and the opioid crisis, Norse says, cannot be overlooked. “Mental illness in this country is a huge issue, one that’s been underserved and underfunded,” she said, and such sentiment is reflected in Pomm’s treatment model, which includes health providers from multiple disciplines.

Cross-disciplinary collaboration is a common experience for JU students. The Brooks Rehabilitation College of Healthcare Sciences (BRCHS) is focused on preparing students to join a workforce community of healthcare professionals who provide exemplary service to a diverse population of patients, something best accomplished through collaboration. From the biomechanical assessment of student athletes to the behavioral effect of standing desks, BRCHS majors have multiple opportunities to participate in Collaborate JU and other interdisciplinary efforts.

Solving the opioid epidemic, though currently a hot-button topic around the world, was only one of several patient safety conversations held at this year’s Forum.

To read about this and other QSEN sessions, and for additional resources, visit the JU QSEN website.

Dr. Gwen Sherwood, Professor and Associate Dean for Global Initiatives at the University of North Carolina at Chapel Hill School of Nursing kicked off the day with a session titled Moving Forward in Patient Safety: A National and International Imperative, and stated that one out of ten patients around the world experience harm during care. Whether local or global, patient safety is of utmost concern to QSEN leaders and participants. “There is no room for competition when it comes to safety,” Sherwood said.

Forum guests included many influencers across northeast Florida and surrounding counties, including Dr. Diane Raines, Senior Vice President and Chief Nursing Officer at Baptist Health; David Massias, Chief Executive Officer at Shadow Health, a company specializing in digital clinical experience and assessment; Dean Leon Haley of UF College of Medicine Jacksonville and Chief Executive Officer of UF Health Jacksonville; and Caroline Sarratt, Operations Administrator at Mayo Clinic.


About the QSEN Institute Regional Center at Jacksonville University

The goal of the QSEN Institute Regional Center at Jacksonville University is to create an international network of healthcare professionals who contribute to quality and safety educational resources and scholarship. The second statewide/regional conference held at JU, the Patient Safety Forum was made possible by JU’s premier Quality and Safety Education for Nurses (QSEN) Institute Regional Center, one of only three in the country.