A Dashboard for Monitoring Opioid-Related Adverse Drug Events Following Surgery Using a National Administrative Database

Stone, Alexander B.; Jones, Mark R.; Rao, Nikhilesh; Urman, Richard D.

doi:10.1177/1062860618782646

Cited by 17 publications

(8 citation statements)

References 25 publications

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“…Dharamshi et al 27 performed a limited usability analysis with an anonymous survey of dashboard users at 6-months after implementation to understand factors that limited the usability of the dashboard. Stone et al 40 iteratively obtained feedback from physician users between dashboard revisions. However, the majority of studies did not describe the use of an informatics or human factors approach that considered usability design principles, user-centred design processes or usability evaluation methods.…”

Section: Resultsmentioning

confidence: 99%

Dashboards for visual display of patient safety data: a systematic review

Murphy

Savoy

Satterly

et al. 2021

BMJ Health Care Inform

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BackgroundMethods to visualise patient safety data can support effective monitoring of safety events and discovery of trends. While quality dashboards are common, use and impact of dashboards to visualise patient safety event data remains poorly understood.ObjectivesTo understand development, use and direct or indirect impacts of patient safety dashboards.MethodsWe conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, EMBASE and CINAHL for publications between 1 January 1950 and 30 August 2018 involving use of dashboards to display data related to safety targets defined by the Agency for Healthcare Research and Quality’s Patient Safety Net. Two reviewers independently reviewed search results for inclusion in analysis and resolved disagreements by consensus. We collected data on development, use and impact via standardised data collection forms and analysed data using descriptive statistics.ResultsLiterature search identified 4624 results which were narrowed to 33 publications after applying inclusion and exclusion criteria and consensus across reviewers. Publications included only time series and case study designs and were inpatient focused and emergency department focused. Information on direct impact of dashboards was limited, and only four studies included informatics or human factors principles in development or postimplementation evaluation.DiscussionUse of patient-safety dashboards has grown over the past 15 years, but impact remains poorly understood. Dashboard design processes rarely use informatics or human factors principles to ensure that the available content and navigation assists task completion, communication or decision making.ConclusionDesign and usability evaluation of patient safety dashboards should incorporate informatics and human factors principles. Future assessments should also rigorously explore their potential to support patient safety monitoring including direct or indirect impact on patient safety.

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Section: Resultsmentioning

confidence: 99%

Dashboards for visual display of patient safety data: a systematic review

Murphy

Savoy

Satterly

et al. 2021

BMJ Health Care Inform

View full text Add to dashboard Cite

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“…12,20 In an attempt to better monitor ORADEs, Stone et al created a system using data from the CMS National Administrative Database to identify potential ORADEs. 13 In using this system, we attempted to understand the impact of potential ORADEs in hip replacement surgery. Understanding this impact may lead health-care providers to question current management of postoperative pain and lead them to develop improved methods of pain management to reduce ORADEs.…”

Section: Discussionmentioning

confidence: 99%

“…This represents approximately 35% of all inpatient hospital discharges in the United States. 13 Hip surgeries were identified by the International Classification of Diseases, 10th Revision ( ICD-10 ) code and were split by Diagnosis-Related Group (DRG) code to account for unmeasured confounders related to patient illness severity. These groups were used to analyze the effect of potential ORADEs on mean hospital LOS and hospital revenue in patients undergoing hip replacement surgery.…”

Section: Methodsmentioning

confidence: 99%

Potential Opioid-Related Adverse Drug Events Are Associated With Decreased Revenue in Hip Replacement Surgery in the Older Population

Baker

Brovman

Rao³

et al. 2020

Geriatr Orthop Surg Rehabil

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Introduction: Opioid-related adverse drug events (ORADEs) are an increasingly recognized complication associated with the common prescription of opioids after orthopedic surgery. In this study, we attempted to understand how potential ORADEs following hip replacement surgery in older patients affected hospital length of stay, hospital revenue, and their association with specific risk factors and clinically relevant diseases occurring during hospitalization. Methods: We conducted a retrospective study using the Centers for Medicare and Medicaid Services Administrative Database to analyze Medicare discharges after hip replacement surgery to identify potential ORADEs. The impact of potential ORADEs on mean hospital length of stay (LOS) and hospital revenue was analyzed. Results: The potential ORADE rate in patients who underwent hip replacement surgery was 8.6%. The mean LOS for discharges with a potential ORADE was 1.41 days longer than that for discharges without an ORADE. The mean hospital revenue per day with a potential ORADE was US$1708 less than without an ORADE. Potential ORADEs were also found to be strongly associated with poor patient outcomes such as pneumonia, septicemia, and shock. Discussion: Potential ORADEs in hip replacement surgery in older patients are associated with longer hospitalizations, decreased hospital revenue per day, certain patient risk factors, and clinically relevant diseases occurring during hospitalizations. Our finding of an association between potential ORADEs and decreased hospital revenue per day may be attributed to the management of these adverse events, as a patient may need to undergo additional testing, may need additional treatment regimens, and may need a higher level of care. Conclusion: By reducing the use of opioids and employing a multimodal analgesic approach, we may improve patient care, decrease hospital lengths of stay, and increase hospital revenue

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“…More recently, the use of clinical dashboards to provide feedback to clinicians and managers has been increasing, with many studies being published within the last decade [19,20]. Clinical dashboards have been used in a variety of healthcare settings.…”

Section: Discussionmentioning

confidence: 99%

A Dashboard Prototype for Tracking the Impact of Diabetes on Hospital Readmissions Using a National Administrative Database

Wong

Brovman

Rao³

et al. 2020

J Clin Med Res

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Background: Over the past several decades, diabetes mellitus has contributed to a significant disease burden in the general population. Evidence suggests that patients with a coexisting diabetes diagnosis consume more hospital resources, and have higher readmission rates compared to those who do not. Against the backdrop of bundled-payment programs, healthcare systems cannot underestimate the importance of monitoring patient health information at the population level. Methods: Using the data from the Centers for Medicare and Medicaid Services (CMS) administrative claims database, we created a dashboard prototype to enable hospitals to examine the impact of diabetes on their all-cause readmission rates and financial implications if diabetes was present at the index hospitalization. The technical design involved loading the relevant 10th revision of International Classification of Diseases (ICD-10) codes provided by the medical team and flagging diabetes patients at the claim. These patients were then tagged for readmissions within the same database. The odds ratios were determined based on data from two groups: those with diabetes at index hospitalization which include type 1 only, type 2 only, and type 1 and type 2 diabetes, plus those without diabetes at index hospitalization. Results: The dashboard presents summary data of diabetes readmissions quality metrics at a national level. Users can visualize summary data of each state and compare odds ratios for readmissions as well as raw hospitalization data at their facility. Dashboard users can also view data classified by a diagnosis-related group (DRG) system. In addition to a "national" data view, for users who inquire about data specific to demographic regions, the DRG view can be further stratified at the state level or county level. At the DRG level, users can view data about the cost per readmissions for all index hospitalization with and without diabetes. Conclusions: The dashboard prototype offers users a virtual interface which displays visual data for quick interpretation, monitors changes at a population level, and enables administrators to benchmark facility data against local and national trends. This is an important step in using data analytics to drive population level decision making to ultimately improve medical systems.

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A Dashboard for Monitoring Opioid-Related Adverse Drug Events Following Surgery Using a National Administrative Database

Cited by 17 publications

References 25 publications

Dashboards for visual display of patient safety data: a systematic review

Dashboards for visual display of patient safety data: a systematic review

Potential Opioid-Related Adverse Drug Events Are Associated With Decreased Revenue in Hip Replacement Surgery in the Older Population

A Dashboard Prototype for Tracking the Impact of Diabetes on Hospital Readmissions Using a National Administrative Database

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