The Michigan Surgical Quality Collaborative (MSQC) / Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) Collaborative meeting was held on Friday, April 21, 2023, at the Michigan Union in Ann Arbor, Michigan. 

We want to thank all our speakers for their amazing and inspirational talks, especially Dr. Bradford Berndt and Denise Schwerin from Bronson Healthcare - Kalamazoo who served on the panel to discuss beta-lactam allergy screening. Their insights were helpful as quality leaders consider implementing similar initiatives at their local hospital. 

The morning ended with a fun trivia game pitting ASPIRE against MSQC using questions from the morning presentations. We are pleased to report that ASPIRE won the game and were awarded the Greatest of All Time (GOAT) trophy for the second year in a row! 

It was a phenomenal day packed with discussions, open dialogue, and networking. If you attended and need CME or were unable to attend and would like to review the recordings or slides, please see our post MSQC/ASPIRE wrap-up page.



Please join us in welcoming the University of Alabama at Birmingham to MPOG!

Congratulations to Cleveland Clinic for completing the conversion to Import Manager!

The Executive Board elections were held in April. Please welcome our newest Executive Board members: Drs. Dan Berkowitz, Hugh Hemmings, and Peggy McNaull to their 3-year terms. Learn more about the new executive board members on our website.

The Executive Board is comprised of department or practice chairs from active MPOG sites and are elected by a vote of all chairs from active MPOG sites. They provide guidance to MPOG in areas of strategic and operational importance. We look forward to working with them in the coming years. 

Thank you to all the department and practice chairs for their continued support of MPOG. See our website for a complete list of executive board members.

MPOG’s membership includes a vast array of experts. We have featured Dr. Bradford Berndt from Bronson Hospital, Dr. Clark Fisher from Yale University, and Dr. Sunny Lou from Washington University over the past several months.

Read more about them on our Featured Member page.

Randomizations for the THRIVE feasibility study were completed on March 16, ahead of schedule. The feasibility study was a resounding success and highly informative to help refine the design of the full study. The team successfully randomized 300 patients. 53% of patients we spoke to agreed to consent to the study and 97% of patients received the anesthetic technique they were randomized to. For the two co-primary outcomes, 93% of patients completed the Quality of Recovery-15 instrument and 97% of patients completed the awareness survey (Brice).

We are preparing for the full-scale phase of the study. We are currently reaching out to sites who have expressed interest in participating. The enthusiasm from our MPOG partners is energizing. Thank you for your continued support.

Conflicting evidence exists regarding the risks and benefits of inotropic therapies during cardiac surgery, and the extent of variation in clinical practice remains understudied. Therefore, the authors sought to quantify patient-, anesthesiologist-, and hospital-related contributions to variation in inotrope use.



Mathis MR, et al. Patient-, Clinician-, and Institution-level Variation in Inotrope Use for Cardiac Surgery: A Multicenter Observational Analysis. Anesthesiology. April 2023. 

The team investigated the association of patient characteristics, surgical procedure, and perioperative anesthetic course with postoperative opioid consumption and pain three months post-surgery. They hypothesized patient characteristics and intraoperative factors predict opioid consumption and pain three months post-surgery.

Kuck K, et al. Prolonged Opioid Use and Pain Outcome and Associated Factors after Surgery Under General Anesthesia: A Prospective Cohort Association Multicenter Study. Anesthesiology. Jan 2023. 

SUS-03: New sustainability metric (similar to SUS-02) limited to the induction period of anesthesia. Average kg CO2 equivalents per case (induction only) are reported. This is an informational measure with no threshold established. Sites are encouraged to review variation in performance to determine if opportunities exist. 

GLU-06-CARD Now available on Cardiac dashboards! This new process measure identifies ­patients ≥18 years old undergoing open cardiac surgery with a blood glucose value greater than 180 mg/dL. 



The Cardiac Subcommittee met on April 5th. The meeting was led by cardiac anesthesiologist and MPOG Cardiac Subcommittee Chair, Allison Janda, and attended by more than 20 members including cardiac anesthesiologists, perfusionists, and nurses from across the country. The subcommittee reviewed preliminary results for the GLU-06-C measure that identifies cases with any blood glucose value greater than 180mg/dl. The subcommittee agreed to maintain the GLU-06-C measure definition that aligns with the STS guidelines. However, they recommend subsequent measures be released to assess treatment of hyperglycemia and hypoglycemia specifically for open cardiac cases. To review the full GLU-06-C measure specification, please reference the Cardiac Subcommittee meeting minutes. Additional communication regarding the new glycemic management measures will be posted to the Basecamp Cardiac Subcommittee forum. Thanks to all participants for their engagement in the discussion! 

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

The Obstetric Subcommittee met February 15th and led by MPOG OB Subcommittee Chair, Dr. Monica Servin. Thanks to all participants! This meeting was well attended by both anesthesiologists and nurses from MPOG sites. MPOG Research Director and Cardiac Anesthesiologist, Dr. Mike Mathis discussed research opportunities and outlined the proposal process. Dr. Robert Nicholson, an anesthesiologist currently practicing at Bronson Methodist Hospital in Kalamazoo, Michigan, shared outcomes from a quality improvement initiative aimed at improving antibiotic timing for cesarean deliveries.

Our next meeting is scheduled for May 24th at 1pm. The tentative agenda includes Body Mass Index (BMI) stratification for obstetric patients, ABX-01-OB measure review, and the use of second line uterotonic medications. Agenda will be posted to the Basecamp forum soon! Please contact Nicole Barrios if interested in joining.  

The pediatric subcommittee met on March 13, 2023. A recording of the pediatric subcommittee meeting and minutes can be found on our website.   

Dr. Vikas O’Reilly-Shah (Seattle Children’s) led the review of the intraoperative normothermia measure TEMP-04-peds. The subcommittee members voted to modify multiple aspects of this measure to better serve pediatric patients and revisions are underway. Dr. Jay Deshpande (Wake Up Safe) led a discussion on how quality improvement groups in pediatric anesthesia could collaborate more efficiently. Lastly, Dr. Eva Lu-Boettcher (University of Wisconsin) presented an overview of a low flow, weight-based sustainability metric for pediatrics (SUS-06-Peds). The group discussed details of this measure and expressed interest in having MPOG build a sustainability toolkit specific to pediatrics.   

Our next meeting will be in June. Please contact Meridith Bailey if interested in joining the subcommittee.  

50277 Anesthesia Ready for Procedure – New concept to be used if your Anesthesia Ready variable means ready to head back to OR. Update your mapping to this concept if appropriate.  

50018 AACD Anesthesia Ready / Induction End Date/Time – The concept name was updated from AACD Anesthesia Ready Date/Time to include Induction End. Use this for Anesthesia Ready variables that mean induction end.   

50005 Induction End Date/Time – This concept will be retired. If you have any variables mapped to this concept, please update it to one of the above concepts as appropriate.  

2041 Irrigation—New concept under Administration Route 

2042 Injection – Not Specified—New Administration Route concept created. Epic has a variable that is used for different types of injections. If you look under ‘Examine’ for this variable and it shows multiple different routes, map it to this concept. 

The MPOG Technical team has started the Spring upgrades, see the April 2023 release notes on our website. The next upgrade is scheduled for October 2023.