Dear MPOG Community,
We have many exciting updates and announcements to share in our 2023 fall newsletter across QI, research, operations and administrative domains.
First, we want to thank all who were able to attend the 2023 MPOG Retreat at the ASA, either in-person in San Francisco or virtually at home. This year’s retreat featured highly engaging talks from external speakers; research findings from our inaugural year MPOG Research Fellows; and visions for how MPOG may contribute to a potentially emerging education mission.
Next, we extend a warm welcome to our newest member institutions, Johns Hopkins and Temple University! We are excited to have your talented clinicians, researchers, educators and administrators join our community. We look forward to the contributions you will inevitably make to our field.
We are also thrilled to welcome Dr. Tony Edelman as an Associate Quality Improvement Director; please learn more about him below.
MPOG clinical trial research continues to gain momentum – with both THRIVE entering its full-scale phase, and the Initiative for Multicenter Pragmatic Anesthesiology Clinical Trials (IMPACT) progressing to a full proposal phase based upon highly competitive Letters of Intent submitted.
We are reaching an inflection point of rapid growth, development, and impact, reverberating through our field of anesthesiology. Looking forward to what’s to come, and how MPOG can help shape our future.
Best Wishes,
Mike Mathis
| |
We would like to extend our heartfelt gratitude to all those who attended the MPOG Retreat in San Francisco on Friday, October 13, 2023. The event was a resounding success, bringing together healthcare professionals from around the world to engage in thought-provoking discussions and knowledge sharing.
We were honored to have two distinguished keynote speakers grace our event - Dr. Ziad Obermeyer and Dr. Julia Adler-Milstein. Their expertise and insights enlightened attendees on the latest advancements in healthcare analytics and technology, paving the way for innovative approaches to patient care.
The "Best of MPOG" session was a highlight of the retreat, and we want to thank Drs. Clark Fisher, Sunny Lou, and Lucy Everett. These esteemed experts within the MPOG community shared their experiences and expertise, discussing cutting-edge research, clinical outcomes, and quality improvement initiatives. It was an invaluable opportunity for attendees to learn from the best in the field and gain a deeper understanding of how MPOG is shaping modern healthcare practices.
We ended the day learning from Drs. Alex Macario and Julie Huffmyer on how we can leverage MPOG as an educational platform. After their exciting talks we are looking forward to what lies ahead. The insights gained from this session will guide us as we develop our educational content.
The retreat also provided ample networking opportunities for attendees to connect with peers, exchange ideas, and foster collaborations. We witnessed fruitful conversations among clinicians, researchers, and quality improvement administrators that will undoubtedly lead to future advancements in perioperative care.
As we reflect on this successful retreat, we are excited about what lies ahead for MPOG. The insights gained from this event will guide us as we continue our mission to improve patient outcomes through data-driven research. If you were unable to attend the meeting, slides and videos are available on the MPOG Retreat Wrap-up page.
We look forward to meeting again in Philadelphia next year!
| |
ASPIRE Collaborative Meeting | |
The MPOG Coordinating Center recently hosted its 7th Annual ACQR Retreat with 19 nurse quality reviewers (ACQRs) in attendance from across the state of Michigan. We reviewed the 2024 Blue Cross Blue Shield of Michigan Pay-for-Performance (P4P) Scorecard, discussed the upcoming changes to the MPOG Application Suite, and had an opportunity to share challenges and successes from local quality improvement efforts. For the afternoon session, ACQRs divided into small workgroups and generated ideas for presenting measure performance data. Our goal is to add some of those visualizations to the QI Reporting Tool over the next year. Thanks to all our ACQRs for making this day a great success!
| |
Please join us in welcoming Johns Hopkins and Temple Universities to MPOG! | |
The Coordinating Center is pleased to welcome Anthony Edelman, MD, MBA, FASA, as our new MPOG Associate Quality Improvement Director.
Dr. Edelman is a Clinical Assistant Professor of Anesthesiology at the University of Michigan. He currently serves as the Associate Chair for Adult Anesthesiology and the University Hospital Operating Rooms’ Anesthesiology Medical Director. In these roles he provides operational and clinical quality leadership. He previously served as the University of Michigan Medical Group’s Ambulatory Anesthesia Physician Lead. He worked to enhance ambulatory procedural care, standardized pre-procedure evaluation and was responsible for coordination of anesthesia services across multiple ambulatory sites. He has also served as the Chair of the institutional Sedation Committee and Director of Orthopedic Anesthesia. In addition to his medical training from Johns Hopkins University and the University of Michigan, he holds an MBA degree from the University of Michigan’s Ross School of Business, where he graduated with distinction. Prior to returning to the University of Michigan in 2017, he worked for Anesthesia Associates of Ann Arbor, where he was a Managing Partner for seven years and held several clinical and operational leadership positions.
| |
We are delighted to shine the spotlight on one of our esteemed members, Dr. Sharon Reale, MD from Brigham and Women's Hospital. Dr. Reale is a highly accomplished physician with a specialization in obstetric anesthesia. She serves as the MPOG PI, is part of the Obstetric Quality Subcommittee and a moderator for the MPOG Perioperative Clinical Research Committee (PCRC).
Congratulations Dr. Reale!
Read more about her on our Featured Member page.
| |
The full phase of the THRIVE is underway! Our first patients were enrolled at Washington University in St. Louis in September. The University of Michigan and Yale University followed quickly, randomizing their first patients in early October. At the THRIVE Site Investigator meeting, immediately following the MPOG retreat in San Francisco, Dr. Rob Schonberger shared Yale’s start up experiences and lessons learned on their journey to randomizing their first patient. Over the fall we will be onboarding more sites and sharing these early experiences with the entire investigator community! We look forward to having all sites active by the spring of next year.
| |
MPOG Outcomes Research Fellowship | |
The application for the 2024 Outcomes Research Fellowship is now open! The application deadline is November 17, 2023. For more information, please visit the MPOG research fellowship page.
Interested candidates can submit applications to the MPOG Coordinating Center via e-mail to
mpog-research@med.umich.edu.
| |
A new version of the MPOG Standardized Data File (SDF) will be available in early November. This file includes data from 2019-2022 that contains basic patient demographic information, all current MPOG Quality measures, and over 100 MPOG Phenotypes that will allow researchers to answer a wide variety of questions across nearly 10 million cases. Research teams need to go through the usual proposal process and PCRC approval process to receive access to the SDF, but data delivery is expedited and will happen almost immediately upon final proposal approval. For more information, please visit our Standardized Data File page.
| |
Surgical procedures performed on patients with recent exposure to COVID-19 infection have been associated with increased mortality risk in prior studies. Accordingly, elective surgery is often delayed after infection. We aimed to compare 30-day hospital mortality and postoperative complications (acute kidney injury, pulmonary complications) of surgical patients with a prior COVID-19 infection, to a matched cohort of patients without known prior COVID-19. We hypothesized that COVID-19 exposure would be associated with an increased mortality risk.
Aziz MF, et al. Perioperative Mortality of the COVID-19 Recovered Patient Compared to teh Matched Control: A Multicenter Retrospective Cohort Study. Anesthesiology. 2023 Oct 16. Online ahead of print.
| |
The Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) Collaborative Quality Initiative (CQI) was launched as a partnership among hospitals to measure quality, review evidence-based practices, and improve anesthesia-related outcomes. Cost savings and improved patient outcomes have been associated with surgical CQI participation, but the impact of an anesthesia CQI on health care cost has not been thoroughly assessed. In this study, we evaluated whether participation in an anesthesia CQI led to health care savings. We hypothesized that ASPIRE participation is associated with reduced total episode payments for payers and major, high-volume procedures included in the Michigan Value Collaborative (MVC) registry.
Janda AM, et al. Does Anesthesia Quality Improvement Participation Lead to Incremental Savings in a Surgical Quality Collaborative Population? A Retrospective Observational Study. Anesth Analg. 2023 Sep 4. Online ahead of print.
| |
BP-06: New blood pressure management measure identifying the percentage of cases in which MAP was <55 mm/Hg for more than 10 minutes (instead of 20 min with BP-01).
PAIN-03: Recently released pain management metric measure that examines percentage of patients requiring the use of naloxone for opioid reversal from anesthesia start to PACU end.
|
|
QI Reporting Tool Updates | |
Several new updates and bug fixes have been applied to the QI Dashboard (QI Reporting Tool) to improve the user experience. QI Reporting release notes are available on the MPOG website and are updated monthly.
Please contact support@mpog.zendesk.com with questions or feedback regarding this tool.
|
|
The Brain Health & Geriatric Workgroup is interested in studying variation in care for the geriatric population. During the August meeting, participants voted to move forward with an informational measure assessing benzodiazepine use in patients >70 years. The measure specification is available for review: BRAIN-01.
If interested in participating in future meetings hosted by the Brain Health/Geriatric Workgroup, please contact Henrietta Addo.
|
|
The Cardiac Anesthesia Subcommittee last met in September with over 30 participants in attendance. The group reviewed the glycemic management measure specifications, approved the measures for release, and discussed areas of interest for future measure development. Antibiotic administration (timing, selection, and re-dosing) for open cardiac procedures will be the next focus area for the subcommittee. Since the last meeting, two new glycemic management measures for open cardiac procedures (GLU-07 & GLU-08) have been released and are available on the Cardiac Anesthesia dashboard. Cardiac Subcommittee minutes from the meeting are available for review for those who were unable to attend.
The next meeting is scheduled for Friday, December 8, 2023 at 1pm EST and is anticipated to be a closed-review session, open only to those who register prior to the meeting since unblinded glycemic management data will be shared. Please contact Dr. Allison Janda if interested in participating!
| |
The OB Subcommittee last met in May. The group discussed oxytocin labeling practices, voted to exclude patients with placenta accreta from the general anesthesia measures, and completed review of the first obstetric-specific measure: ABX-01. We are excited to see continued interest in the subcommittee and look forward to meeting again on Wednesday, November 8, 2023 at 1pm EST. The agenda for that meeting will include discussion of a new measure for azithromycin administration, BMI stratification for obstetric measures, and a formal review of the hypotension after neuraxial anesthesia measures (BP-04).
The OB Subcommittee is open to all providers interested in improving OB anesthesia care. Please contact Nicole Barrios if interested in joining.
| |
The next Pediatric Subcommittee meeting will be hosted on Monday, December 4, 2023 at 3pm EST. At this meeting the group plans to review and vote on the pediatric multimodal analgesia measure PAIN-01-Peds. We will also provide an MPOG pediatric research update as well as discuss documentation practices and phenotype build surrounding gestational age at birth.
The Pediatric Subcommittee is open to all providers interested in improving pediatric anesthesia care. Please contact Meridith Wade if interested in joining the subcommittee.
| |
The MPOG Application Suite (Fall 2023) has now been released. MPOG's IT will send out the upgrade to each site’s IT contact (if you don’t know who this is for your site, contact support@mpog.zendesk.com)
- Sites Using Desktop Virtualization (e.g. Citrix)
- The site's IT will upgrade the App Suite
- Users using the App Suite installed on their PC
- The site's IT will distribute the installer to all individuals at their site after the database upgrade has been applied.
MPOG Application Suite (Fall 2023) release notes.
| |
New Concepts
3332 Processed EEG Monitor – Unspecified Device EMG Trend
3333 Processed EEG Monitor - Unspecified Device Suppression Ratio
| |
The neuromuscular monitoring concepts (train-of-four) have been renamed to enable future QI and research projects. | |
The Lactate concepts have been updated, and some new concepts were added to signify values reported in mmol/L and values reported in mg/dL. | | | | |