Hospital Nursing: PM Conversation (Revenue Cycle) Bed Transfer Cancel Discharge (Revenue Cycle) Decision Guide: Patient Status, Accommodation, and Bed Transfer (Requires Network Access) Discharge Discharge Encounter Discharge Encounter When Transferring to Different MHC Hospital Modify Encounter Change Accommodation (Level of Care) Change Patient Status Change Provider Overview

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Vitamin D Assay Test Ordering Guidance Vitamin D testing may NOT be used for routine screening or ordered as part of a panel and is subject to frequency limitations.  If the patient is vitamin D deficient, further testing may be medically necessary only to ensure adequate replacement has been accomplished for this vitamin deficiency, although generally, other parameters are measured. Annual testing of the vitamin D status may be appropriate depending on indication and other mitigating factors. If vitamin D testing is clinically indicated, include supporting documentation. A few examples when

Clinical Reminders for Prescribing Opioids Opioids are not first-line or routine therapy for chronic pain. Use non-pharmacologic therapy as appropriate. Establish and measure goals for pain and function. Talk with your patient about the benefits and risks of opioid therapy and availability of non-opioid therapies. When starting therapy, use immediate-release opioids; start low and go slow. When opioids are needed for acute pain, prescribe no more than needed; three days or less is often sufficient; more than seven days is rarely needed. Do not prescribe ER/LA opioids for acute pain. Follow up

Toolkits, Downloadable Documents & Forms Forms  Start Talking Consent for Controlled Substances Containing Opioids (Form 11930) Start Talking Consent for Controlled Substances Containing Opioids (Spanish Form 11959) Start Talking Consent for Controlled Substances Containing Opioids - Cadillac-Grayling (Form NUR21023)   Opioid Start Talking Informed Consent Form - State of Michigan's Version Opioid Patient Information (Form #11973) Downloadable Documents PDFs (Opioid Rx, Risks, Information Flyer) https://michigan-open.org/resources/materials/ Useful Links  CDC Overdose Prevention MHA Tools and

Pain Management Strategies Each person recovers from procedures in their own way, and two people having the same procedure might have completely different experiences of pain. Pain after procedures is normal and is a body’s sign that it is healing. Patients should balance activity with rest. Pain is an uncomfortable but natural part of recovery. While everyone feels pain differently, typically procedural pain is the worst during the first 2-3 days and then begins to get better. Opioids are not the first-line therapy for pain management. The goal of pain management is to do activities of daily

Opioid Prescribing Requirements The state of Michigan enacted legislation regulating opioid prescriptions in 2018. This includes: Establish a legitimate provider-patient relationship Register on the Michigan Automated Prescription System (MAPS) Obtain a patient’s complete medical history on MAPS Provide information to patients describing: The dangers of opioid addiction How to properly dispose of unused opioid drugs The fact that delivery of a controlled substance is a felony in Michigan The effects of exposing unborn babies to a controlled substance (applies to all pregnant and female

Talking Points and Resources for Patients The Michigan Opioid Prescribing Engagement Network (MI-OPEN) has multiple tools that can be displayed in waiting areas or shared patients to educate them about opioid laws and how they may impact their care. Messages for Your Patients Opioids can reduce pain during short-term use, but there is no evidence that opioids control chronic pain long-term. Exercise, non-opioid medications, and other therapies are typically more effective with less harm. Regular follow up visits are important during opioid therapy. Precautions include checking drug monitoring

Substance Use Disorder Treatment & Resources Addiction is far more complicated than a matter of “poor choices” or willpower. It's a medical condition requiring an individualized, patient-centered treatment plan. Watch as Dr. Jim Whelan explains the powerful dopamine effect of substances such as opioids, drugs, alcohol, and even nicotine on the brain – and how this influences recovery. More than 760,000 people have died since 1999 from a drug overdose. Nearly 75% of drug overdose deaths in 2020 involved an opioid. Beyond opioids, an average of 4,548 annual deaths in Michigan are attributable to

Pregnancy and Substance Use Disorder Neonatal Withdrawal Syndrome (NWS) Services for our Communities Neonatal Withdrawal Syndrome (NAS) is a group of side effects that can occur when an infant is exposed to certain substances while in the womb. These substances can include things like caffeine, tobacco, certain medications, herbal remedies, and supplements. When a baby is used to being supplied with substances like these while in the womb, withdrawal can occur after the baby is born. Key Points Buprenorphine and methadone are safe and effective during pregnancy and breastfeeding. Both are