Improved Compliance With Anesthesia
Quality Measures After Implementation of
Automated Monthly Feedback
Patrick J. McCormick, MD MEng
Assistant Attending
Vice Chair for Informatics
Department of Anesthesiology & CCM
Memorial Sloan Kettering Cancer Center
October 17, 2019
Assistant Professor of Clinical Anesthesiology
Weill Cornell Medical College
Disclosures
• None
MPOG and ASPIRE at a Cancer Center
Background on Memorial Sloan Kettering Cancer Center:
– 1884: founded as the “New York Cancer Hospital”
– 1971: named one of the first three Comprehensive Cancer
Centers
– 2017: first cancer center contributing to MPOG
– September 2017: began ASPIRE monthly emails
– Performs 50,000 anesthetics per year at 5 sites in NY/NJ
– ~60 attending anesthesiologists, ~120 CRNAs
– All surgical specialties except OB, trauma, cardiac, transplant
MSKCC NYPH/Cornell
Introduction to ASPIRE
• Staff Meeting to discuss concept, timeline
• Concerns regarding use of individual results
• Elected to not observe certain measures we did not agree with
– PUL 02: Low tidal volume, ≤ 8 mL/kg IBW
– FLUID 01: Minimizing colloid use
• ASPIRE champions discussed 1:1 in OR with attendings and CRNAs
McCormick PJ et al. J Oncol Pract 2019;15:e583-92.
Results for Process Measures
McCormick PJ et al. J Oncol Pract 2019;15:e583-92.
Some Lessons
• Reinforcement of quality measure knowledge is difficult
– Must be part of new hire training
– Periodic reminders needed
• Decision support helps
• Core temperature during GA with LMA remains difficult
• PONV problem: steroids can hurt immunotherapy patients
