Elsie Rizk1, Joshua T Swan1,2, Ohbet Cheon2, A Carmine Colavecchia1, Lan N Bui1, Bita A Kash3, Sagar P Chokshi4, Hua Chen5, Michael L Johnson5, Michael G Liebl1, Ezekiel Fink6. 1. Department of Pharmacy, Houston Methodist, Houston, TX. 2. Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX. 3. Center for Outcomes Research, Houston Methodist Research Institute, and School of Public Health, Texas A&M University, TX. 4. Department of Neurosurgery, Houston Methodist Hospital, Houston, TX. 5. Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX. 6. Department of Neurology, Houston Methodist Hospital, Houston, TX.
Abstract
PURPOSE: The purpose of this project was to develop a set of valid and feasible quality indicators used to track opioid stewardship efforts in hospital and emergency department settings. METHODS: Candidate quality indicators were extracted from published literature. Feasibility screening excluded quality indicators that cannot be reliably extracted from the electronic health record or that are irrelevant to pain management in the hospital and emergency department settings. Validity screening used an electronic survey of key stakeholders including pharmacists, nurses, physicians, administrators, and researchers. Stakeholders used a 9-point Likert scale to rate the validity of each quality indicator based on predefined criteria. During expert panel discussions, stakeholders revised quality indicator wording, added new quality indicators, and voted to include or exclude each quality indicator. Priority ranking used a second electronic survey and a 9-point Likert scale to prioritize the included quality indicators. RESULTS: Literature search yielded 76 unique quality indicators. Feasibility screening excluded 9 quality indicators. The validity survey was completed by 46 (20%) of 228 stakeholders. Expert panel discussions yielded 19 valid and feasible quality indicators. The top 5 quality indicators by priority were: the proportion of patients with (1) naloxone administrations, (2) as needed opioids with duplicate indications, and (3) long acting or extended release opioids if opioid-naïve, (4) the average dose of morphine milligram equivalents administered per day, and (5) the proportion of opioid discharge prescriptions exceeding 7 days. CONCLUSION: Multi-professional stakeholders across a health system participated in this consensus process and developed a set of 19 valid and feasible quality indicators for opioid stewardship interventions in the hospital and emergency department settings.
PURPOSE: The purpose of this project was to develop a set of valid and feasible quality indicators used to track opioid stewardship efforts in hospital and emergency department settings. METHODS: Candidate quality indicators were extracted from published literature. Feasibility screening excluded quality indicators that cannot be reliably extracted from the electronic health record or that are irrelevant to pain management in the hospital and emergency department settings. Validity screening used an electronic survey of key stakeholders including pharmacists, nurses, physicians, administrators, and researchers. Stakeholders used a 9-point Likert scale to rate the validity of each quality indicator based on predefined criteria. During expert panel discussions, stakeholders revised quality indicator wording, added new quality indicators, and voted to include or exclude each quality indicator. Priority ranking used a second electronic survey and a 9-point Likert scale to prioritize the included quality indicators. RESULTS: Literature search yielded 76 unique quality indicators. Feasibility screening excluded 9 quality indicators. The validity survey was completed by 46 (20%) of 228 stakeholders. Expert panel discussions yielded 19 valid and feasible quality indicators. The top 5 quality indicators by priority were: the proportion of patients with (1) naloxone administrations, (2) as needed opioids with duplicate indications, and (3) long acting or extended release opioids if opioid-naïve, (4) the average dose of morphine milligram equivalents administered per day, and (5) the proportion of opioid discharge prescriptions exceeding 7 days. CONCLUSION: Multi-professional stakeholders across a health system participated in this consensus process and developed a set of 19 valid and feasible quality indicators for opioid stewardship interventions in the hospital and emergency department settings.
Authors: Sara J Hyland; Kara K Brockhaus; William R Vincent; Nicole Z Spence; Michelle M Lucki; Michael J Howkins; Robert K Cleary Journal: Healthcare (Basel) Date: 2021-03-16
Authors: Patrice Forget; Champika Patullo; Duncan Hill; Atul Ambekar; Alex Baldacchino; Juan Cata; Sean Chetty; Felicia J Cox; Hans D de Boer; Kieran Dinwoodie; Geert Dom; Christopher Eccleston; Brona Fullen; Liisa Jutila; Roger D Knaggs; Patricia Lavand'homme; Nicholas Levy; Dileep N Lobo; Esther Pogatzki-Zahn; Norbert Scherbaum; Blair H Smith; Joop van Griensven; Steve Gilbert Journal: BMC Health Serv Res Date: 2022-03-12 Impact factor: 2.655