Clinical Decision Support BPA for
Sevoflurane
Dr. Blake Wilson, Director of MyMichigan Anesthesia Quality
Wendy Owens, RN, MSN
MyMichigan Health System
Alma – 4,885 Cases
Alpena – 7,734 Cases
Clare – 2,609 Cases
Gladwin – 379 Cases
Midland – 19,299 Cases
West Branch – 3,169 Cases
Sault – 3,546 Cases
41,621 Anesthesia
Cases in 2024
BPA halogenated gases
pushed live and
removed by IT – No
anesthesia guidance
Collaboration with
Quality Champions,
ACQR, IT, and CRNA
Manager (May 23, 2024)
BPA
Parameters set
to align with
SUS-02
Measure
BPA live June 13, 2024
Education sent out to
providers
Monthly
Meetings, data
review and set
goals
P4P and VBR
Target
Performance
met
SUS-02 Goals
2024 P4P 45% (Measurement Period 01/01/24 – 12/31/24)
2025 P4P 55% (Measurement Period 01/01/25 – 12/31/25)
Parameters
BPA triggers after induction and will prompt if Sevoflurane is greater than 2% and FGF is
greater than 1.8L/min over a 10-minute period average
Acknowledge Reasons
• Provider selects Follow-up actions taken – BPA repeats after lockout of 15 minutes
and will fire again if rate is high
• Provider selects Does not meet criteria – BPA lock out for 360 hours, only for current
user and current encounter
BPA
SUS-02 Performance
MyMichigan Health System SUS-02
June 2023 – June 2024 (Fiscal Year)
35%
55%
MyMichigan Health System SUS-02
June 2024 – May 2025 (Fiscal Year)
55%
65%
Alma SUS-02
January 2024 – December 2024
50%
76%
New Anesthesia
Machines
26%
Improvement
Alpena SUS-02
January 2024 – December 2024
66%
69%
Desflurane Removed
Clare SUS-02
January 2024 – December 2024
52%
57%
Midland SUS-02
January 2024 – December 2024
55%
61%
West Branch SUS-02
January 2024 – December 2024
67%
79%
EPIC Community Library
comlibepic.com
Future Direction
Near term- Removing case duration lock-out and decrease FGF goal <1.4L/min,
and change of BPA lockout from 15 min to 10 min
Long term- Decision support real-time feedback on reduced Greenhouse gas
usage performance
Traffic light decision support tool - Display a Red-Yellow-Green based on ongoing
moving average
Provide immediate feedback of CO2 equivalent calculation
