Holland Hospital
Anesthesia Quality 2018
Where we’ve been, Where we’re going
Numbers
Holland Hospital Anesthesia Department
• 200 bed independent hospital
• 7 ORs
• 1 ASC (3 ORs)
• 3 Endoscopy rooms
• 26 room L/D floor (1800 deliveries/year)
• Health Pointe 2018 addition
• Independent private practice
• Holland Hospital partner since 1992
• Currently 14 physicians, 10 CRNAs
• 20,000 anesthetics per year
Macatawa Anesthesia
Macatawa Anesthesia
• Network
• Hospital
• Practice
• Individual
Quality
• Reorganized as Integrated Network in 2014
• Governing Board
• Contracting committee
• Quality and Care Management committee
• Reorganized as i
Holland PHO
• Hyperglycemia screening prior to implant surgery
• Pre-op total joint optimization
• Perioperative anti-coagulant management
PHO QCM
Total Joint Optimization
Anti-coagulant Management
• How Are We Doing?
• MSPC
• Physician Feedback Report
• ASPIRE
Holland Hospital
Physician Feedback Report
• Journal Club
• QA Forms
• ASPIRE
• Quality Officer
Macatawa Anesthesia
Monthly Dinner Meeting
Take turns presenting on a variety of topics
• Block additives
• Stagger rooms
• NM reversal
• Isobaric spinals
• ASPIRE Measures
• Block a
Journal Club
QA Forms
Take-aways from self-reported
data
• Only the conscientious get
penalized
• People who need the most
help won’t accept it
• Example of something that
didn’t/doesn’t work
• Improvements in all measures
• Thanks! BCBSM and especially UM crew
• Temperature management and NMB most notable
ASPIRE
Aspire Measures
Active warming or temp ≥36ºC
82%
81%
84%
84%
85%
84%
84%
87%
89%
92%
93%
94% 94%
0%
20%
40%
60%
80%
100%
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1
2015 2016 2017 2018
Temp 01
Aspire Measures
Core temp documented
45%
46%
45%
49%
54%
61%
67%
77%
78%
80%
90%
89%
92%
0%
20%
40%
60%
80%
100%
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1
2015 2016 2017 2018
Temp 02
Aspire Measures
Documentation of TOF
46%
46%
53%
54%
69%
73%
80%
91%
94%
93%
96%
98%
95%
0%
20%
40%
60%
80%
100%
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1
2015 2016 2017 2018
NMB 01
Aspire Measures
NMB Reversal given
82%
81%
83%
82%
87%
92%
93%
98%
98%
97%
99%
99%
99%
0%
20%
40%
60%
80%
100%
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1
2015 2016 2017 2018
NMB 02
• ASPIRE e-mails/MOCA
• Physician Feedback Report
HAWD cards
Performance Measures
Citizenship
• HAWD
Individual
• Timing of obstetric epidural placement
• PACU pain evaluation
• Intraop/postop narcotics
Future
