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Brief description of measure
CMS819/HH-03: Hospital Harm - Opioid-Related Adverse Events
This measure assesses the proportion of inpatient hospital encounters where patients ages 18 years of age or older have been administered an opioid medication and are subsequently administered an opioid antagonist (naloxone) within 12 hours, an indication of an opioid-related adverse event. This measure excludes opioid antagonist (naloxone) administration occurring in the operating room setting.
Description of issue
During Spring 2022, feedback from public comment and external review of the measure included a recommendation to exclude opioids given in the operating room (OR) from the measure calculation. The measure developer's internal clinical leads agree with this recommendation, as most general anesthesia cases involve opioid administration.
Measure testing confirmed that there is variability in how hospitals document medications administered in the OR; in some cases, documentation of OR medications are not done within the EHR, potentially creating an imbalance in eCQM rates across hospitals because so many patients receive opioids in the OR. Most general anesthesia cases involve opioid administration for pain control and rapid induction. Thus, the measure denominator could easily be twice as high in hospitals that document OR meds in the EHR versus those who do not.
Goal of review
Obtain clinical and technical feedback
Show
Brief description of measure
CMS819/HH-03: Hospital Harm - Opioid-Related Adverse Events
This measure assesses the proportion of inpatient hospital encounters where patients ages 18 years of age or older have been administered an opioid medication and are subsequently administered an opioid antagonist (naloxone) within 12 hours, an indication of an opioid-related adverse event. This measure excludes opioid antagonist (naloxone) administration occurring in the operating room setting.
Description of issue
During Spring 2022, feedback from public comment and external review of the measure included a recommendation to exclude opioids given in the operating room (OR) from the measure calculation. The measure developer's internal clinical leads agree with this recommendation, as most general anesthesia cases involve opioid administration.
Measure testing confirmed that there is variability in how hospitals document medications administered in the OR; in some cases, documentation of OR medications are not done within the EHR, potentially creating an imbalance in eCQM rates across hospitals because so many patients receive opioids in the OR. Most general anesthesia cases involve opioid administration for pain control and rapid induction. Thus, the measure denominator could easily be twice as high in hospitals that document OR meds in the EHR versus those who do not.
Goal of review
Obtain clinical and technical feedback