MPOG Colleagues,


So many exciting projects and events occurring across MPOG! It’s nearly impossible to keep up with everything, but we try to provide the highlights in these quarterly newsletters. Please take a few minutes to read and join me in welcoming our new Outcomes Research Fellows from UCSF, and especially our new administrative assistant, Frances.


Sincerely,

Nirav


ASPIRE Collaborative Meeting

The registration for the ASPIRE Collaborative meeting on Friday, July 14, 2023 at the Henry Executive Center is now open.


We are looking forward to seeing everyone in Lansing!


Register for the ASPIRE Collaborative meeting

MSQC / ASPIRE Collaborative Meeting

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.



Welcome UAB

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

Import Manager Conversions

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

New Executive Board Members

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.

Featured 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.

THRIVE Update

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.

2023 Outcomes Research Fellows

We are pleased to welcome our 2023 Outcomes Research Fellows. This one-year fellowship offers researchers from active MPOG sites the opportunity to engage in a practicum capstone project using the MPOG data infrastructure, while receiving mentorship from MPOG’s nation-wide experts from over 60 hospitals. We are pleased to welcome Drs. Erica Langnas and Roberta Teixerira Tallarico from the University of California San Francisco. Learn more about the new Outcomes Research Fellows on our website.

Recent Publications

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. 

Quality

Measure Updates

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. 



New Sustainability Toolkit

Climate change has become one of the most important public health issues of our time. Anesthesia providers can be part of the solution. As anesthetic agents can be significant environmental pollutants, MPOG has developed a  Sustainability Toolkit that provides guidance to reduce our global warming footprint associated with anesthesia care. 

Quality Subcommittees

Cardiac

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. 

Obstetrics

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.  

Pediatrics

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.  

Concept Updates

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. 


Technical Updates

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.

Welcome New Staff

Join us in welcoming our new Administrative Assistant. 

 

Hi, I am Frances Guida Smiatacz, I graduated in the Philippines with a bachelor's degree in commerce Major in Business Administration in 2004. I moved to the United States in 2015 met my husband who also works at Michigan Medicine and now have 2 kids, Amaris (6) and Arkyn (4). I worked at Kellogg Eye Center as a patient services assistant before I joined your amazing team.  



I am excited to be part of MPOG and look forward to getting to know you all! 

Pediatric Prescribing Recommendations

Michigan OPEN has released a new set of Pediatric Prescribing Recommendations based on three years of data collection and analysis of prescribing patterns and patient reported outcomes. These recommendations add nearly 40 new procedures to our extensive list centered around pediatric surgeries. 

We are excited to announce we have joined LinkedIn. Please take a moment to visit and subscribe to our MPOG LinkedIn page.  

MPOG | Website
Twitter  LinkedIn  Web