Decoding High MME Opioid Usage: A Root Cause Analysis of Henry Ford Jackson Hospital's Outlier Status within the System

Document Type

Conference Proceeding

Publication Date

1-8-2025

Publication Title

Am J Health Syst Pharm

Abstract

Purpose: The purpose of this study is to define the root cause of high morphine milligram equivalents usage, defined as morphine milligram equivalents (MME) greater than 50 milligrams, within Henry Ford Jackson Hospital compared to other hospitals within the Henry Ford Health System. By conducting this analysis, the study aims to uncover factors contributing to the elevated opioid prescribing rates at Henry Ford Jackson Hospital and to explore strategies to optimize prescribing practices, thereby improving patient safety and reducing the risk of opioid misuse. Methods: The inclusion criteria for this study require participants to be adults aged 18 or older admitted to Henry Ford Jackson Hospital between January 1, 2023, and January 1, 2024. They must have received at least one scheduled order of morphine or a morphine equivalent (e.g., buprenorphine, codeine, hydromorphone, fentanyl, methadone, oxycodone, or tramadol) at a dosage of 50 MME or greater during their hospital stay. Exclusion criteria include hospice patients or individuals with terminal illnesses receiving palliative care, intubated patients on fentanyl infusion, and vulnerable groups such as children, pregnant women, and incarcerated individuals. This study will use a retrospective, descriptive medication use evaluation design. Historical data from electronic medical records will be reviewed to assess opioid prescribing practices and protocols. The study will employ statistical and qualitative analyses to identify patterns and discrepancies in high MME prescribing, focusing on opioid trends, departmental variations, and adherence to naloxone protocols. A cohort of eligible patients will be compiled through data extraction, with each assigned a unique identifier. Using a random number generator, 100 patients will be randomly selected from this pool, replacing any who meet exclusion criteria. Extracted data will include patient medical record number (MRN), admitting diagnosis, opioid prescription details, naloxone orders, pain scale, order set used, authorizing prescriber, and primary service.

Volume

82

First Page

S326

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