Opioids play a central role in pain management in acute hospital settings, especially after surgery and trauma. Appropriateness and the volume of opioid prescriptions on discharge can be optimised using OSDash.
Background
Pain is a common reason for an emergency department (ED) presentation and opioids are frequently prescribed, while in hospital and on discharge, as patients are often sent home before their pain has completely resolved. Opioid related improvement initiatives in EDs have focused on decreasing discharge opioid prescribing by limiting the quantity and the number of prescriptions.
There are no optimum rates of opioid prescribing and therefore prescribing rates often reflect a combination of an over reliance on opioids for pain management and a representation of contextual influences such as access to specialist services, pain focus education and resources i.e. differences such as access to specialist services, pain focus education and resources.
It is important to identify ways to improve pain management and clinical handover especially on discharge from Emergency Departments to ensure that opioid prescribing rates are an accurate reflection of holistic pain management rather than an unbalanced reliance on opioids. Therefore, while there is an opportunity to use data analytics as a means for ongoing assessment of practice and for benchmarking purposes, it has to be undertaken with an understanding of contextual differences.
Development and implementation of OSDash
The first phase of the Opioid Stewardship implementation used an opioid focussed quality improvement initiative OOPPS (Optimising Opioid Prescribing Projects) to introduce concepts of opioid stewardship to EDs. OOPPS is an educational intervention which uses prescribing data and clinical leadership as integral components of the program. The data matrix for the OSDash was developed using the results of consultation with the Clinical Leads of OOPPS at each pilot site. The dashboard includes population and individual-facility reports, which will be supported by accompanying guidance documents.
The evaluation of the implementation of OSDash across the three pilot sites will inform the future direction of this program. AIM to evaluate the implementation of the Opioid Stewardship Dashboard (OSDash) in Emergency Departments across the three pilot hospitals, the Sunshine Coast University Hospital, Mackay Base Hospital and the Townsville University Hospital.
Objective
- Describe improvement to practice using routinely collected opioid prescribing data from each pilot site
- Assess clinician and system-level barriers and facilitators to implementing OSDash
Methods to undertake this research using two data sources
- Routinely collected opioid prescribing data
- Responses to OSDash clinical leads survey and OSDash key stakeholder survey
OS_DASH is undergoing evaluation
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