ASPIRE Quality Committee
Meeting
June 22nd, 2020
Agenda
• Upcoming events
• COVID procedure reports across
MPOG
• Mortality specification and voting
• Measure review process
Meeting Minutes
April 2020
Roll Call – via webex or
contact us
Upcoming Events
ASPIRE Virtual Summer
Meeting
July 17
th
2020
Michigan sites
performance review
Speakers
Gary Loyd, MD Matt Wixson, MD
2020 Quality
Committee
Meetings on
Monday
MPOG Annual Retreat
October 2
nd
2020
virtual – details TBD
Cardiac Subcommittee:
thank you for your
interest!
What happened across
MPOG during COVID?
-
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
200,000
January-20 February-20 March-20 April-20
MPOG Case Volume
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
50,000
January February March April
2020
MPOG Case Volume- Michigan Sites Only
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
January February March April
2020
Neuraxial for Labor Epidural Cases
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
January February March April
2020
Total Hip Arthroplasty Cases
-
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
January-20 February-20 March-20 April-20
MPOG Cases - Emergent Status
Measure Updates
In hospital mortality (MORT 01)
Glycemic management
MORT 01 Exclusions
• Measurement of in hospital 30 day mortality rate
• Exclusions developed after literature review and discussion at the
coordinating center
• Intended to exclude cases where inpatient mortality is highly unlikely
due to procedural or anesthetic care
MORT 01 Exclusions - Poll
Please use Webex poll to provide feedback.
• v
• ASA 6
• Central Line Placement (CPT 00532)
• Diagnostic Imaging/Radiology (CPT 01922)
• Gastrointestinal Endoscopy (CPT 00731, 00740, 00810, 00811, 00812, 00813)
• ECT (CPT 00104)
• Electrophysiologic Procedures (CPT 00537)
• Lithotripsy (CPT 00872, 00873)
• External Cephalic Procedure (CPT 01958)
• Pain procedures (CPT 01991, 01992, 01995, 01996)
• Bronchoscopy (CPT 00520)
• Cardioversion(CPT 00410)
• If no, what changes would you suggest?
MORT 01 Calculation
• Post-operative mortality ratio literature supports calculation where each
patient who died counts only once in the numerator, but each procedure
counts individually in the denominator
• Example: A patient has a Whipple procedure, had multiple bring backs for
anastomotic leaks, and then died of sepsis. The patient would count once
in the numerator, but all cases would be counted in the denominator.
• Represents the risk associated with each case
MORT 01 Calculation - Poll
Please use Webex poll to provide feedback
• Do you agree with the following calculation for determining inpatient
morality?:
• If no, what changes do you suggest?
Final question: Overall measure voting – Use
Webex
• Choose one of the following:
• Accept
• Accept with revisions
• Reject
Glycemic Management Survey Results
• Thank you to everyone who participated – 35 responses!
• Measure update plan
• Will keep hyperglycemia threshold at 200mg/dL for glucose measures as opposed
to lowering to 180mg/dL (60% vs. 34%)
• Will keep timeframe for treatment of hyperglycemia at 90 minutes as opposed to
shortening to 60 minutes (63% vs. 34%)
• Will develop treatment measure (54% support)
• Will require two escalating glucose measurements before requiring treatment, instead of only
one high glucose measurement (61 vs. 39%)
• Will include Preop through PACU in the measure (81%)
• Will maintain institution level attribution only for hyperglycemia in preop and PACU
for GLU 03
Measure Review Process
Background
• MPOG QI measures need to be reviewed to stay current and relevant.
• MPOG QI measures may be “topped out” or no longer relevant for QI, and
should be retired
• Should reflect latest evidence and consensus of the MPOG Quality
Committee
• MPOG Quality Champions have tremendous experience and expertise that
should be leveraged
• All MPOG measures should be reviewed every three years
Plan
• Coordinating Center will create a review schedule for all measures
• Coordinating Center will request MPOG Quality Champions and other MPOG
members to sign up for measure review
• Coordinating Center may also assign/ request specific members to review
measures in their area of expertise.
• Reviewers will make one of the following recommendations (with supporting
information)
• Continue measure as is
• Modify measure
• Retire measure
Considerations
• Coordinating Center will not assign more than 1-2 measures per year/ per
Quality Champion
• Coordinating Center may assign multiple members for a single measure or
group of measures
• Reviewers will be de facto members of MPOG Quality Improvement
Measure Workgroup
• Coordinating Center team will assist reviewers as necessary to complete
review process
Microbiology Concepts
MPOG Lab Concepts - Microbiology
• New Microbiology Category with prefix ‘Micro’
• Culture type (aerobic, anaerobic, AFB etc.)
• Specimen type (wound, CSF, fluid etc.)
• Immunology – Antibody tests
• COVID-19 Related Concepts available
• Micro – Virology – Novel Coronavirus
(COVID-19)
• Immunology – Antibody – COVID19 - IgG
MPOG Concept
Name
Concept
ID
Micro
- Virology - Novel Coronavirus (COVID-19)
3403
Immunology
- Antibody - COVID19 - IgG
3404
Micro
- Culture - Aerobic (blood)
5155
Micro
- Culture - AFB (blood)
5156
Micro
- Culture - AFB (non-blood)
5157
Micro
- Culture - Anaerobic
5158
Micro
- Culture - Anaerobic (blood)
5159
Micro
- Culture - Fungus
5160
Micro
- Culture - Fungus (blood)
5161
Micro
- Culture - Yeast
5162
Micro
- Culture (blood)
5163
Micro
- Culture (CSF)
5164
Micro
- Culture (deep tissue)
5165
Micro
- Culture (foreign body)
5166
Micro
- Culture (IV catheter tip)
5167
Micro
- Culture (non-sterile body fluid)
5168
Micro
- Culture (respiratory)
5169
Micro
- Culture (sterile body fluid)
5170
Micro
- Culture (stool)
5171
Micro
- Culture (urine)
5172
Micro
- Culture (urogenital)
5173
Micro
- Culture (wound)
5174
Micro
- Isolate - Staphlococcus
5175
Micro
- Isolate - VRE
5176
Micro
- Virology - Adenovirus
5177
Micro
- Virology - Astrovirus
5178
Micro
- Virology - Coronavirus (SARS-CoV-2)
5179
Micro
- Virology - Human Metapneumovirus
5180
Micro
- Virology - Human Rhinovirus-Enterovirus
5181
Micro
- Virology - Norovirus
5182
Micro
- Virology - Parainfluenze Virus
5183
Micro
- Virology - Respiratory Synctial Virus
5185
Micro
- Virology - Rotavirus
5184
Micro
- Virology - Sapovirus
5186
Immunology
- Antibody - IgA Total
5187
Immunology
- Antibody - IgG total
5188
Immunology
- Antibody - IgM Total
5189
Immunology
- Antibody - IgG/IgM
5190
Thank you
