Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings

Research output: Contribution to journalArticle

Elsie Rizk, Joshua T Swan, Ohbet Cheon, A Carmine Colavecchia, Lan N Bui, Bita A Kash, Sagar P Chokshi, Hua Chen, Michael L Johnson, Michael G Liebl, Ezekiel Fink

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.

Original languageEnglish (US)
Pages (from-to)225-235
Number of pages11
JournalAmerican Journal of Health-System Pharmacy
Volume76
Issue number4
DOIs
StatePublished - Feb 1 2019

PMID: 30715186

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Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings. / Rizk, Elsie; Swan, Joshua T; Cheon, Ohbet; Colavecchia, A Carmine; Bui, Lan N; Kash, Bita A; Chokshi, Sagar P; Chen, Hua; Johnson, Michael L; Liebl, Michael G; Fink, Ezekiel.

In: American Journal of Health-System Pharmacy, Vol. 76, No. 4, 01.02.2019, p. 225-235.

Research output: Contribution to journalArticle

Harvard

Rizk, E, Swan, JT, Cheon, O, Colavecchia, AC, Bui, LN, Kash, BA, Chokshi, SP, Chen, H, Johnson, ML, Liebl, MG & Fink, E 2019, 'Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings' American Journal of Health-System Pharmacy, vol. 76, no. 4, pp. 225-235. https://doi.org/10.1093/ajhp/zxy042

APA

Rizk, E., Swan, J. T., Cheon, O., Colavecchia, A. C., Bui, L. N., Kash, B. A., ... Fink, E. (2019). Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings. American Journal of Health-System Pharmacy, 76(4), 225-235. https://doi.org/10.1093/ajhp/zxy042

Vancouver

Rizk E, Swan JT, Cheon O, Colavecchia AC, Bui LN, Kash BA et al. Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings. American Journal of Health-System Pharmacy. 2019 Feb 1;76(4):225-235. https://doi.org/10.1093/ajhp/zxy042

Author

Rizk, Elsie ; Swan, Joshua T ; Cheon, Ohbet ; Colavecchia, A Carmine ; Bui, Lan N ; Kash, Bita A ; Chokshi, Sagar P ; Chen, Hua ; Johnson, Michael L ; Liebl, Michael G ; Fink, Ezekiel. / Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings. In: American Journal of Health-System Pharmacy. 2019 ; Vol. 76, No. 4. pp. 225-235.

BibTeX

@article{aec4ffad1b0f4938a1b9cbf65d9dd06d,
title = "Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings",
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-na{\"i}ve, (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.",
keywords = "Opioid stewardship, Pain, Pharmacists, Quality indicators",
author = "Elsie Rizk and Swan, {Joshua T} and Ohbet Cheon and Colavecchia, {A Carmine} and Bui, {Lan N} and Kash, {Bita A} and Chokshi, {Sagar P} and Hua Chen and Johnson, {Michael L} and Liebl, {Michael G} and Ezekiel Fink",
year = "2019",
month = "2",
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doi = "10.1093/ajhp/zxy042",
language = "English (US)",
volume = "76",
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RIS

TY - JOUR

T1 - Quality indicators to measure the effect of opioid stewardship interventions in hospital and emergency department settings

AU - Rizk, Elsie

AU - Swan, Joshua T

AU - Cheon, Ohbet

AU - Colavecchia, A Carmine

AU - Bui, Lan N

AU - Kash, Bita A

AU - Chokshi, Sagar P

AU - Chen, Hua

AU - Johnson, Michael L

AU - Liebl, Michael G

AU - Fink, Ezekiel

PY - 2019/2/1

Y1 - 2019/2/1

N2 - 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.

AB - 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.

KW - Opioid stewardship

KW - Pain

KW - Pharmacists

KW - Quality indicators

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UR - http://www.scopus.com/inward/citedby.url?scp=85060940079&partnerID=8YFLogxK

U2 - 10.1093/ajhp/zxy042

DO - 10.1093/ajhp/zxy042

M3 - Article

VL - 76

SP - 225

EP - 235

JO - American Journal of Health-System Pharmacy

T2 - American Journal of Health-System Pharmacy

JF - American Journal of Health-System Pharmacy

SN - 1079-2082

IS - 4

ER -

ID: 45182293