2019 Quality Improvement Projects

By focusing on two project areas in 2019 we hope to increase the impact our work has on the lives of surgical patients across Michigan. The Colectomy Care Pathway Project was developed based on our previous work creating the colon bundle, a group of evidence-based practices shown to decrease surgical site infection rates for colectomy patients. The Opioid Prescribing Project is a continuation of the 2018 project and continues the efforts of Michigan OPEN and MSQC to address the opioid epidemic by targeting excess opioid prescribing after surgery.


Colectomy Care Pathway Project

The focus of this project is to work toward the development and implementation of a care pathway to improve the outcomes of patients undergoing elective colectomy surgery. Using widely accepted clinical practice guidelines as a starting point, hospitals will develop their own colectomy care pathway. We hope that this project will inspire multidisciplinary discussions to standardize, document and drive best practice at each hospital to improve the lives of surgical patients.


Postoperative Opioid Prescribing Project

The focus of this project is to reduce the number of opioids prescribed by MSQC surgeons, educate patients regarding pain management and opioid safety, prevent opioid diversion into the community, and increase patient awareness of safe opioid use and proper disposal. By focusing on a more evidence-based approach to prescribing and better patient education, we hope to improve the patient experience that is commonly impacted by postoperative pain.

Resources

Opioid Dose Conversions

For the purposes of the 2019 QI Project, any discharge prescription for a drug other than 5 mg Oxycodone will be converted to OME in order to determine whether or not the prescribing recommendation was exceeded.

To determine the total oral morphine equivalent (OME) of a discharge prescription, use this equation:

CONVERSION FACTOR x PILL DOSE x TOTAL NUMBER OF PILLS GIVEN

Table of Opioid Oral Morphine Milligram Equivalent (MME) Conversion Factors from the CDC