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Related Experiment Videos

Georgia Quality Improvement Programs Multi-Institutional Collection of Postoperative Opioid Data Using ACS-NSQIP

Jesse A Codner1, Elissa A Falconer1, Dennis W Ashley2

  • 1Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA.

The American Surgeon
|March 25, 2022
PubMed
Summary

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Developing a multi-institutional opioid data collection platform is feasible. The Georgia Quality Improvement Program (GQIP) identified significant variation in opioid-sparing strategy (OSS) use and overprescribing, highlighting areas for quality improvement.

Area of Science:

  • Surgical Quality Improvement
  • Pain Management
  • Public Health

Background:

  • Excessive postoperative opioid prescribing fuels the US opioid crisis.
  • The Georgia Quality Improvement Program (GQIP) is a collaboration of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP).
  • GQIP aimed to establish a multi-institutional opioid data collection platform to analyze opioid-sparing strategy (OSS) usage and postoperative opioid prescribing patterns.

Purpose of the Study:

  • To assess the feasibility of developing a multi-institutional opioid data collection platform.
  • To understand current opioid-sparing strategy (OSS) usage and postoperative opioid prescribing patterns across participating centers.
  • To identify variations in OSS use and opioid overprescribing for quality improvement initiatives.

Related Experiment Videos

Main Methods:

  • Four custom ACS-NSQIP variables were created to capture OSS use and oral morphine equivalents (OMEs).
  • Variable optimization from free text to drop-down selections improved data capture from 26% to 70%.
  • Logistic regression analyzed associations with OSS usage; average OMEs were compared to national guidelines for 820 patients across 10 general surgery operations (2/2020-5/2021).

Main Results:

  • Optimized data collection significantly increased the percentage of calculable discharge prescription OMEs (70%).
  • Significant variation in OSS usage was observed among GQIP centers.
  • Laparoscopic procedures showed higher odds of OSS use (1.92), while Black patients had lower odds (0.69) on univariate analysis. Seven of ten procedures exceeded national guideline OME recommendations.

Conclusions:

  • Establishing a multi-institutional opioid data collection platform via ACS-NSQIP is achievable.
  • Preselected drop-down variables are superior to free-text fields for data capture.
  • Future GQIP quality improvement efforts will target observed variations in OSS use and opioid overprescribing.