Your Resource for HQIC News and Learning Opportunities | August 2022 |
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Opioid Safety and Stewardship |
An adverse drug event (ADE) is an injury resulting from a medical intervention related to a drug.1 This includes medication errors, adverse drug reactions, allergic reactions, and overdoses.
Recent studies examining opioid use for surgical and endoscopic cases identified a 9 percent to 11 percent opioid-related ADE (ORADE) rate, which was associated with significantly worse patient outcomes, including increased inpatient mortality, greater likelihood of discharge to another care facility, prolonged length of stay, high cost of hospitalization, and a higher rate of 30-day readmissions.2,3
Intravenous opioid administration increased a patient’s odds of experiencing an ORADE by 18 percent for each day of treatment.3 Serious consequences of perioperative opioid misuse and dependence include increased inpatient mortality, morbidity, and resource utilization.4 Additionally, opioids prescribed during and after surgery may trigger long-term use in patients regardless of their opioid-tolerance status, whether they were taking opioids regularly prior to surgery or were ever exposed to opioids in the past.2,3,5,6 Extra caution is needed for patients with ORADE risk factors, such as sleep apnea, renal disease, concurrent use of sedatives, prior opioid exposure, advanced age, male gender, chronic obstructive pulmonary disease, and neurological disorders.7
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It Figures—Data and Performance |
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Opioid Progress
Data show that opioid measures have improved since the baseline period of 2019 (lower rates are better). Visit the HSAG HQIC Quality Improvement Innovation Portal (QIIP) to view your Opioid Measure Progress by selecting the “Measure Category” of Adverse Drug Events and the “Measure” of ADE Opioid, Benzo Co-Prescribing, and MME 90.
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*Rates are per 1,000 admissions.
Source: Medicare Fee-for-Service (FFS) claims data. For additional details on measure specifications, please reference the HSAG HQIC Compendium of Measures. The baseline time period is 01/01/2019–12/31/2019, and the current time period is 03/01/2021–02/28/2022.
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ADE Opioids—Roadmap to Success
This HSAG HQIC document assists your team in building an opioid stewardship program for your facility. The roadmap includes strategies and links to tools and resources related to prevention, treatment, safer care, patient and family engagement, and community best practices.
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Substance Abuse and Mental Health Services Administration (SAMHSA) Website
Learn how medication-assisted treatment (MAT) is used to treat substance use disorders, as well as sustain recovery and prevent overdose. MAT is the use of medications in combination with counseling and behavioral therapy for a whole-person approach.
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HSAG HQIC Webinar Recording: Using MAT in the Emergency Department (ED)
Andrew Herring, MD, medical director at Alameda Health System and principal investigator for California (CA) Bridge, reviews the impact of the opioid crisis and patients with opioid use disorder who present in the ED, and discusses the importance of beginning MAT in the ED.
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MAT programs are clinically driven and individualized to meet patient needs. This treatment approach has been shown to improve patient survival, increase retention in treatment, decrease illicit drug use and associated criminal activity, increase the patient’s ability to sustain employment, and improve birth outcomes among pregnant patients with substance use disorders.
The CA Bridge Navigator Program has recently received new funding to support all California hospital EDs with evidence-based addiction treatment. This program provides financial support and technical assistance to every California hospital ED to ensure all people experiencing substance use disorder and mental illness have access to care.
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Coming September 13! Phase 2: HSAG Care Coordination Series |
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Register for the continuation of the Care Coordination Quickinar Series. Phase 2 continues your care coordination journey for managing avoidable hospital readmissions. Offered every month through July 2023. |
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References
3 Shafi S, Collinsworth AW, Copeland LA, et al. Association of Opioid‐Related Adverse Drug Events With Clinical and Cost Outcomes Among Surgical Patients in a Large Integrated Health Care Delivery System. JAMA Surg. 2018;153(8):757–763. doi:10.1001/jamasurg.2018.1039. https://jamanetwork.com/journals/jamasurgery/fullarticle/2680703
5 Hah JM, Bateman BT, Ratliff J, Curtin C, Sun E. Chronic Opioid Use After Surgery: Implications for Perioperative Management in the Face of the Opioid Epidemic. Anesth Analg. 2017;125(5):1733–1740. doi:10.1213/ANE.0000000000002458. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119469/
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This material was prepared by Health Services Advisory Group (HSAG), a Hospital Quality Improvement Contractor (HQIC) under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication No XS-HQIC-XT-08042022-01 |
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