Testing a Novel Inpatient Respiratory Depression Electronic Clinical Quality Measure (eCQM) for Orthopedic Practice...

Area of Science:

• Healthcare Quality Improvement
• Clinical Informatics
• Patient Safety Research

Background:

• Inpatient respiratory depression is a significant safety concern following major orthopedic surgery.
• Accurate measurement of respiratory depression rates is crucial for quality improvement initiatives.
• Electronic health records (EHRs) offer a potential data source for clinical quality measures.

Purpose of the Study:

• To evaluate the feasibility of using an electronic clinical quality measure (eCQM) to assess inpatient respiratory depression.
• To determine the reliability and validity of eCQMs for tracking respiratory depression rates after total hip or total knee arthroplasty.
• To identify variations in respiratory depression rates across different clinical groups and health systems.

Main Methods:

• Retrospective analysis of routinely collected EHR data from two large academic health systems.
• Development and testing of an eCQM for inpatient respiratory depression following elective primary total hip or total knee arthroplasty.
• Risk-adjustment of calculated respiratory depression rates.

Main Results:

• Risk-adjusted inpatient respiratory depression rates were 3.83% and 2.73% in the two participating health systems.
• Clinician group rates for respiratory depression varied widely, ranging from 1.40% to 4.35%.
• The eCQM demonstrated strong reliability and validity for accurate and comparable rate calculation.

Conclusions:

• Electronic clinical quality measures are feasible and reliable tools for assessing inpatient respiratory depression.
• The developed eCQM can support quality improvement efforts by identifying areas for enhanced patient safety.
• Findings underscore the potential for using routinely collected EHR data to monitor and improve surgical patient care.