S:  In validating the Safe Use Opioids- Concurrent Prescribing Measure we noted that some patients pulling into the population include patients that transition from the inpatient setting to a Transitional Care unit. 

B:  These units are designed to assist the patient in recovering after their inpatient care when they aren’t ready to return home yet. 

A:  These patients have inpatient orders that transfer to the transitional care unit upon discharge from the inpatient setting.  They are not outpatient prescriptions.  I see the only exclusions included for this measure at discharging to another acute facility, discharged to hospice, or expired.

Denominator Exclusions:  Inpatient hospitalizations where patients have cancer that begins prior to or during the encounter or are receiving palliative or hospice care (including comfort measures, terminal care, and dying care) during the encounter, patients discharged to another inpatient care facility, and patients who expire during the inpatient stay

Denominator Exclusions:

• • Excludes encounters of patients with cancer or who are receiving palliative or hospice care at the time of the encounter/
  • "Inpatient Encounters with an Opioid or Benzodiazepine at Discharge" InpatientEncounter
  • where exists ( ["Diagnosis": "All Primary and Secondary Cancer"] Cancer
  • where Cancer.prevalencePeriod overlaps InpatientEncounter.relevantPeriod
  • )
  • or exists ( "Inpatient Encounters with an Opioid or Benzodiazepine at Discharge" InpatientEncounter
  • where exists InpatientEncounter.diagnoses Diagnosis
  • where Diagnosis.code in "All Primary and Secondary Cancer"
  • )
  • or exists ( "Intervention Palliative or Hospice Care" PalliativeOrHospiceCare
  • where Coalesce(start of Global."NormalizeInterval"(PalliativeOrHospiceCare.relevantDatetime, PalliativeOrHospiceCare.relevantPeriod), PalliativeOrHospiceCare.authorDatetime)during Global."HospitalizationWithObservation" ( InpatientEncounter )
  • )
  • or exists ( "Inpatient Encounters with an Opioid or Benzodiazepine at Discharge" InpatientEncounter
  • where InpatientEncounter.dischargeDisposition in "Discharge To Acute Care Facility"
  • or InpatientEncounter.dischargeDisposition in "Hospice Care Referral or Admission"
  • or InpatientEncounter.dischargeDisposition in "Patient Expired"
  • )

 ** 

R:  Is the measure intent to pick up patient who do not return to their home setting after hospital discharge, like in a transitional care unit?