Thank you for an educational and collaborative MPOG Retreat in New Orleans, Louisiana. Thanks to all our wonderful speakers for an inspiring series of lectures, panels, and discussions.

We want to send a special thank you to Dr. Talmage Egan for his thoughtful presentation on TIVA, Dr. Ramani Moonsinghe for joining us from the UK to discuss the NHS perioperative quality improvement program, Dr. George Mashour for his informative discussion on interoperative awareness, and Dr. Maxime Cannesson for his presentation on closed loop anesthesiology.

An additional thanks to Drs. Bethany Pennington, Josh Billings, and Mike Burns for sharing their successes and challenges during the Best of MPOG session and Drs. Jeffrey Feldman, Elizabeth Hansen, and Seema Gandhi for participating on our sustainability panel which summarized their experiences and perspectives on sustainability at their institutions.

This collaboration and sharing of ideas are the core component to our group and so important to our mission. If you were unable to attend the meeting, slides and videos are available on the MPOG Retreat Wrap-up page.

Planning is already underway for our next retreat in San Francisco on Friday, October 13, 2023. Save the date and we hope to see you there! 

Please join us in welcoming the following sites to MPOG!

Congratulations to these sites for recently completing conversion to Import Manager!

Rounding out 2022, we were delighted to have Dr. Meredith Hall from Bronson Battle Creek as our featured member for November and December. Dr. Hall is doing some amazing quality improvement work at her institution.

Kicking off 2023, we are excited to feature Dr. Amit Bardia from Yale. Dr. Bardia was awarded an R01 Grant from AHRQ that examines the association of IDSA-nonadherence with Surgical Site Infections.

Read more about Drs. Hall and Bardia on our  Featured Member page.

The THRIVE feasibility study continues to make exceptional progress. We are now past the halfway point and enrollment is proceeding ahead of schedule. The majority of patients we speak to at the University of Michigan and Washington University in St. Louis agree to participate in the study. We continue to be thankful for the support of the clinical teams for providing patients with outstanding clinical care and delivering the randomized anesthesia technique. We are excited to test the feasibility of distributing wearable devices to patients in the first quarter of 2023. 

Welcome to MPOG’s newest Perioperative Clinical Research Committee (PCRC) moderators and a big thank you to everyone who continues to serve on the PCRC Moderator Committee!

Dr. Amit Bardia

Massachusetts General Hospital

Dr. Catherine Chen

University of California

San Francisco

Dr. Brad Fritz

Washington University in Saint Louis

Dr. Jaime Privratsky

Duke University

Dr. Sharon Reale

Brigham and Women's Hospital

The annual Standardized Data File (SDF) is now available! This file contains many of the commonly requested phenotypes and other data elements for MPOG cases meeting the intraoperative research standard from January 1, 2016 to December 31, 2021. Use of the Standardized Data File provides researchers with faster access to relevant MPOG data after their PCRC presentation is approved. More information about the SDF can be found in the SDF User Guide and on the SDF page.

The application for the 2023 Outcomes Research Fellowship is now open! The application deadline is February 10, 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.

The objective of this study was to examine whether supraphysiological oxygen administration during surgery is associated with lower or higher postoperative kidney, heart, and lung injury.

McIlroy DR, et al. Oxygen administration during surgery and postoperative organ injury: observational cohort study. BJM 2022.

The objective of this study was to investigate institutional variation in albumin use among medical centers in the United States during major non-cardiac surgery and explore the association of intraoperative albumin administration with important post-operative outcomes.

Lazzareschi DV, et al. Intraoperative Use of Albumin in Major non-cardiac surgery: Incidence, Variability, and Association with Outcomes. Ann Surg 2022

The objective of the study is to determine the association of age and sex groups on postoperative AKI. The authors hypothesized that younger females would display lower risk of postoperative AKI than males of similar age, and the protection would be lost in older females.

Privratsky JR. Postoperative acute kidney injury by age and sex: a retrospective cohort association study. Anesthesiology 2022

PONV 05: The adult postoperative nausea and vomiting prophylaxis measure, PONV 05, was released in early 2022 to align with the Fourth Consensus Guidelines. The measure was recently updated based on recommendations proposed at the May and November MPOG Quality Committee meetings. Revisions were published in early December and are now reflected on site dashboards.

TEMP 07: The MPOG Cardiac Anesthesia Subcommittee recently released an outcome measure identifying adult cases with hyperthermia while on cardiac bypass. This is a counter measure to the hypothermia measure (TEMP 06) that was released earlier this year.

DMS: A revised interface of MPOG’s QI measure browser (Dynamic Measure Spec) is now available. Measure specifications have been updated to list measure contributors as well as a log history of measure updates. 



2022 P4P: Michigan sites should expect to receive their 2022 Pay-for-Performance (P4P) scores the week of January 31 following the December 2022 data upload. The Quality Champions, ACQRs and P4P Administrators from each site will receive their scores via e-mail and will have approximately two weeks to review prior to the final scores being submitted to Blue Cross Blue Shield. 

The Cardiac Subcommittee met in December. 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. Dr. Janda extended an exciting opportunity to cardiac anesthesiologists to participate as peer reviewers in a NHLBI-funded R01 study. The VARSITY Surgery group is examining the relationship between non-technical practices and risk-adjusted complication rates after cardiac surgery. For more information, please contact Dr. Allison Janda via e-mail at ajanda@med.umich.edu.

We are excited to announce that TEMP-07 has been released and is now available on your dashboards!

In addition, the subcommittee participated in the first unblinded data review of cardiac-specific MPOG measures: TEMP 06 and TEMP 07. Thanks to all participants for their engagement in the discussion!

The next cardiac-specific measure, GLU-06-CARD, is in development and will be released in early 2023. This new measure will identify open cardiac cases with any blood glucose value >180mg/dl to align with STS guidelines. To review the full measure specification, please reference the Cardiac Subcommittee 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 March.

The Obstetric Anesthesia Subcommittee also met in December 2022. Per request from the Quality Committee, the subcommittee reviewed TEMP-01 and voted to exclude cesarean deliveries from the measure as there is insufficient evidence to support active warming in this patient population. The subcommittee also discussed the new obstetric measure, GA-03-OB, which is scheduled to be released in early 2023.

The subcommittee expressed interest in examining oxytocin administration after cesarean delivery. As such, MPOG distributed a survey to subcommittee members, and we will present the results at our February meeting.

Special thanks to Dr. Ashraf Habib and Nicole Zanolli for presenting their research project examining anesthetic management of cesarean hysterectomy in patients with placenta accreta!

The notes, recording, and slides are available for review on the MPOG website. The next meeting is scheduled for February 15, 2023 at 1pm Eastern. Please contact Nicole Barrios if interested in joining.

MPOG is pleased to announce Dr. Vikas O’Reilly-Shah (Seattle Children’s Hospital) as the new pediatric subcommittee vice-chair. He will serve a two-year term in this role alongside subcommittee chair, Dr. Brad Taicher (Duke University). 

The last Pediatric subcommittee meeting was held on November 30, 2022. Dr. Taicher gave an update on the state of MPOG Pediatrics which now includes 27 active pediatric MPOG sites and over 2.3 million pediatric cases in the MPOG database. In addition, two multi-center research projects were discussed: Evaluation of Pediatric PON Prophylaxis Guidelines (Dr. Lucy Everett, Mass General Hospital) and Pediatric Mortality (Dr. Ruchika Sharma, University of Virginia).

The notes, recording, and slides are available for review on the MPOG website. Please contact Meridith Bailey if interested in joining the subcommittee.

Epic sites will start to see many more services populating in the Procedure Service mapping group within Variable Mapping. We have been working with Epic to improve the procedure service accuracy when a case is booked as an appointment, which is currently categorized as ‘Unspecified Service.’ When your site applies the FEB 2023 Epic upgrade, these appointments will have their own variables with the prefix ‘PRC.’ This may result in a significant increase in the number of variables under Procedure Service in Variable Mapping. The Coordinating Center recommends that any PRC variable with a low row count remain unmapped. Please contact the MPOG Coordinating Center with any questions on how to map these variables or any requests for new concepts.

MPOG released an update to the Application Suite in early January 2023. 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. See the release notes on our website.