ASPIRE Quality Committee
Meeting
August 24, 2020
Agenda
• Announcements
• Measure Review Process: Follow Up
• Multimodal Pain Measure Vote
• Data Review: New Measures
• Dashboard 2.0 Feedback
Meeting Minutes
June 2020
Roll Call – via webex or
contact us
Con
Con
Congrats UAMS for IM conversion!
Thank you
New QI Champions
Bryan Cohen, MD
Henry Ford West Bloomfield
Emily Drennan, MD
University of Utah
Special thanks to Amber Bledsoe and Billy Hightower for their
contributions as MPOG QI Champions!
Upcoming Events
MPOG Annual Retreat
October 2
nd
2020
10:00 - 2:30pm ET
virtual
gvddg
Topics
CMS perspective on Quality Improvement
Perioperative Healthcare Disparities
Best of MPOG - Research and QI
MPOG Development, Research, and QI
updates
• October 26, 2020
2020 Quality
Committee
Meetings
Remaining
Measure Updates
GLU-05 in Development
Glycemic Management - Measure update plan
• Will keep hyperglycemia threshold at 200 mg/dL for glucose measures
as opposed to lowering to 180 mg/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 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
• Check out the list here
Measure Proposal
Multimodal Pain Management
Multimodal Anesthesia - continue?
Description: Percentage of patients ≥ 18 years old who undergo a surgical or therapeutic procedure and receive a
non-opioid adjunct preoperatively and/or intraoperatively.
Measure Time Period: Preop Start → Anesthesia End
Success: At least one non-opioid adjunct medication was administered to the patient during the preoperative or
intraoperative period.
Responsible Provider: Provider at the beginning of the case (prior to incision)
Exclusions:
● ASA 5 and 6
● Patients transferred directly to ICU
● Organ Harvest (CPT: 01990)
● Cardiac Surgery (CPT: 00561, 00562, 00563, 00566, 00567, 00580)
● Non-operative procedures and Radiology procedures.
Multimodal Anesthesia - considerations
1. How should regional/neuraxial techniques be
incorporated into the measure?
2. Should opioid administration be an inclusion criteria (ie
we exclude cases without no opioid administered)?
3. Which medications should be considered non-opioid
adjuncts?
10007 Acetaminophen
10222 Ibuprofen
10747 Naproxen
10116 Celecoxib
10239 Ketorolac
10238 Ketamine
10149 Dexmedetomidine
10199 Gabapentin
10570 Pregabalin
10132 Clonidine
10705 Magnesium
10477 Lidocaine (IV only)
Vote
Question
If yes, please let us know if interested in developing a measure spec
with us
Data Review
In-Hospital Mortality
Antibiotic Timing
Pediatric Temperature Management
Opioid Equivalency: Tonsil/Adenoid
MORT 01: In-hospital Mortality
MORT 01 Institution Comparison
1.5%
ABX 01 (OB) – Antibiotic Timing for Cesarean Delivery
• First obstetric-anesthesia MPOG measure
• Released July 15, 2020
• Description: Percentage of cesarean deliveries with documentation of antibiotic
administration initiated within one hour before surgical incision
• Inclusions: Elective, urgent, or emergent cesarean delivery & patients undergoing
cesarean section with hysterectomy
• Exclusions: Obstetric non-operative procedures & C-section with documented infection
before incision
• Success: Documentation of at least one antibiotic administration within one hour of
surgical incision
• Threshold: 90%
ABX 01 (OB): Institution Comparison
100%
TEMP 04 (PEDS) – Pediatric Temperature Management
TEMP-04 Performance Comparison
Percentage of patients < 18 years old who undergo a procedure greater than 30 minutes whom
have a median core/near core temperature > 36C (96.8F).
80%
50%
Opioid Equivalency - Tonsil/Adenoid (pediatrics)
• Patients < 18 years old
• Anesthesia for intraoral
procedures, including biopsy; not
otherwise specified (CPT: 00170)
• Procedure text includes "tonsil" or
"adenoid"
• Intraoperative opioid equivalency
displayed in mg/kg/hr.
• Preoperative or PACU opioids
were not included
Opioid Equivalency - Tonsil/Adenoid (pediatrics)
Dashboard 2.0
New Dashboard Feedback
General thoughts - frank feedback
appreciated!
Run time/performance
Ease of navigation
Too cluttered?
Not enough information displayed?
Next Steps
Subcommittee specialty Dashboards (including access)
Individual dashboards
Special Measures (OME, SSI)
Bug fixes and usability enhancements
Thank you
