Thank you to our Michigan colleagues who attended the July ASPIRE Collaborative meeting held in Lansing, Michigan. A special thanks to all our wonderful speakers for an inspiring series of lectures and discussions.   

The morning kicked off with two amazing QI Stories from Dr. Benjamin Stam from University of Michigan West sharing his department's efforts to reduce their carbon footprint and Dr. Meredith Hall from Bronson Health for leading an amazing discussion on glucose management. We were honored to have Dr. Kamal Maheshwari from the Cleveland Clinic as our keynote speaker. He spoke about intraoperative hypotension and adverse outcomes. We concluded with our unblinded performance review session. 

It was a wonderful day packed with discussion, open dialog, and networking. Meeting summary, slides, videos, and pictures are all available on our website.  

The MPOG Coordinating Center recently hosted its 6th Annual ACQR Retreat with 16 nurse quality reviewers (ACQRs) in attendance from across the state. During this retreat, ACQRs had the opportunity to review the 2023 BCBS P4P Scorecard, discuss recent upgrades to several MPOG tools, and were able to collaborate on a variety of QI initiatives. Thanks to all our ACQRs for making this day a great success!  

Please join us in welcoming the Seattle Children's Hospital and Sparrow Carson, Clinton, Ionia, Eaton, and St. Lawrence to MPOG!

We are delighted that Dr. Lucy Everett from Massachusetts General Hospital (MGH) is our featured member for September and October. Dr. Everett is the MGH MPOG IT Champion, and a national leader in perioperative informatics. 

Read more about Dr. Everett on our  Featured Member page.

Congratulations to Dr. Amit Bardia and team for their recently awarded RO1 Grant, funded by the Agency for Healthcare Research and Quality. The studies under this grant examine the association of IDSA-nonadherence with Surgical Site Infections (SSIs) in a nationwide sample and envisages the development and testing of an Electronic Health Record (EHR) based intervention to improve guideline adherent perioperative antibiotics prophylaxis and decrease rates of SSIs. 

The first patients were enrolled into the THRIVE feasibility study in August. THRIVE is currently in the feasibility phase, where 300 patients are being recruited between now and Spring 2023 at University of Michigan and Washington University St. Louis to learn more about study acceptability to patients and clinicians.

Over 20 patients across both institutions have now been randomized to receive either TIVA or inhaled volatile anesthesia. The study team has received overwhelmingly positive feedback from surgeons and anesthesia providers at both institutions. The randomized patients have had good experiences overall, and we are learning from them on a daily basis.

We have been overwhelmed with ongoing interest in the THRIVE study and appreciate the participation of our sites in this exciting project. There will be a Site Investigator Launch Meeting for eligible sites following the MPOG retreat in New Orleans, LA on October 21, 2022.

To read more about the THRIVE study, visit: https://mpog.org/thrive-info/. 

The MPOG Research Team will make a new Standardized Data File available in mid-December 2022. The file will contain many of the most commonly requested phenotypes and other data elements for all MPOG cases that meet the intraoperative research standard from January 1, 2016 to December 31, 2021. Similar to other data requests, access to the Standardized Data File requires PCRC approval, but the data pull process after presentation and approval is expedited by having this data file ready to use. Two proposals that will use the new Standardized Data File will be presented at the November 2022 PCRC meeting. More information about the SDF can be found in the User Guide on MPOG’s website. 

Recent studies have investigated the effect of overlapping surgeon responsibilities or nurse to patient staffing ratios on patient outcomes, but the association of overlapping anesthesiologist responsibilities with patient outcomes remains unexplored to our knowledge.

Burns ML, et al. Association of Anesthesiologist Staffing Ratio with Surgical Patient Morbidity and Mortality. JAMA Surg 2022.

BP-05: New hypotension measure reporting the percentage of adult cases where severe hypotension during anesthesia induction (defined as MAP < 55mmHg) was avoided. See measure specification for more details. 

SUS-03 (PENDING): New sustainability metric similar to SUS-02, however, limited to the induction period of anesthesia. CO2 equivalents, normalized by hour are reported. Plan to release as an informational measure only with no threshold established. Sites are encouraged to review variation in performance to determine if opportunities exist.   

The most recent toolkit focuses on postoperative nausea and vomiting (PONV) prevention and treatment. Previously released ASPIRE toolkits focus on acute kidney injury, lung protective ventilation strategies, transfusion stewardship and surgical site infections.  

All toolkits are available to download from website. 

The Cardiac Subcommittee met in August. Cardiac Subcommittee Chair and cardiac anesthesiologist, Allison Janda, introduced two new research collaboration opportunities. The group also reviewed the ASPIRE sustainability measures and discussed applicability to the cardiac population. Dr. Janda presented a draft measure specification for a new hyperglycemia measure for patients undergoing open cardiac surgery. The subcommittee voted to move forward with hyperglycemia defined as flagging any cardiac case with a blood glucose >180mg/dl to align with the STS guidelines. For full measure specification details and the outcomes of this discussion, please reference the meeting minutes. 

The Cardiac Subcommittee is open to all providers interested in improving cardiac anesthesia care. Please contact Dr. Allison Janda to join our next meeting tentatively scheduled for November. 

The last Obstetric Anesthesia Subcommittee meeting was held on July 20, 2022. Notes, recording, and slides are available for review on the MPOG website. Next meeting is scheduled for December 7, 2022 at 1pm EST. Please contact Kate Buehler if interested in joining.

MPOG is pleased to announce Dr. Brad Taicher (Duke University) as the new pediatric subcommittee chair and will begin his two-year term beginning October 1, 2022. Dr. Taicher previously served as co-chair of this subcommittee with Dr. Bishr Haydar (University of Michigan). We would like to thank Dr. Haydar for his many contributions over the past two years in this role and for his continued participation as a member of the MPOG pediatric subcommittee. 

The next pediatric subcommittee meeting is on November 30, 2022 at 3:00 p.m. Eastern. Additionally, an MPOG Pediatric update will be presented at the Society of Pediatric Anesthesiology (SPA) Quality & Safety meeting on October 22, 2022. For more information about the Pediatric Subcommittee or if you are interested in joining, please visit the Pediatrics Subcommittee webpage or contact support@mpog.zendesk.com. 

MPOG will be releasing an update to the Application Suite in early November 2022. As part of this release, location mapping will have significant changes requiring sites to update their location tier structure and assigning proper ‘tags’ to identify cases by room type. An announcement will be posted to the MPOG website as soon as the upgrade is available for download.