MPOG Colleagues,
Please take a few minutes to see what’s new with MPOG. There is so much energy and activity across our sites and at the Coordinating Center. I’d like to extend a warm welcome to our colleagues at the American University of Beirut, our newest MPOG site! So impressed by their onboarding effort despite the many challenges they faced over the last couple of years. 
As always, many thanks to all of you across MPOG for your amazing research and QI accomplishments. 
Hope to see many of you at the Summer ASPIRE meeting and the MPOG Retreat this October!
Upcoming Events

ASPIRE Collaborative Meeting

Friday, July 15, 2022

Henry Executive Center, MSU
3535 Forest Road
Lansing, MI 48910

ACQR Retreat

Friday, September 16, 2022

DoubleTree Hotel
3600 Plymouth Road
Ann Arbor, MI 48105

MPOG Retreat

Friday, October 21, 2022

Location TBD
New Orleans, LA

Welcome New Sites
Please join us in welcoming the American University of Beirut (AUB) and MyMichigan Alpena, Clare, Gladwin, Gratiot and West Branch to MPOG!
Import Manager
We are pleased to announce that Memorial Sloan Kettering Cancer Center has completed their conversion to Import Manager. Nearly all sites have converted from our legacy extract process. If your site has not yet begun this process, please reach out to the Coordinating Center as soon as possible
Welcome New Executive
Board Members
Brian Bateman, MD, MSc
Stanford University
Kelly McQueen, MD, MPH
University of Wisconsin
Jill Mhyre, MD
University of Arkansas
The Executive Board elections were held in May 2022. Please join us in congratulating our new board members, Drs. Brian Bateman, Kelly McQueen, and Jill Mhyre. We look forward to working with them in the coming years.

Thank you to all the chairs / heads of practice for their continued support of MPOG. See our website for a complete list of board members.
Featured Members
Check out our recently featured members, Dr. T. Wesley Templeton from Wake Forest and Jerri Heiter from St. Joseph Ann Arbor, Chelsea, and Livingston. Read more about their research and quality improvement initiatives on our Featured Members page.
T. Wesley Templeton, MD
May and June 2022
Jerri Heiter, RN
July and August 2022
Congratulations to Drs. Mathis, Singh, and Team for their recently funded R01 Grant, Cardiac sURgery anesthesia Best practices to reduce Acute Kidney Injury (CURB-AKI). The study, funded by the National Institute of Diabetes and Digestive and Kidney Diseases at the NIH, will use cardiac operating room data from over 80,000 patients at over 30 US hospitals participating in MPOG.
It will provide novel, deep insights into how anesthesia practice patterns can be individualized to reduce acute kidney injury. 

To read more about the project, see our website
New Research Facilitator
The MPOG Coordinating Center welcomed Diana O’Dell as our newest research facilitator in June. Diana earned a BS in Human Biology from Lyman Briggs College at Michigan State University and an MPH in Epidemiology from Boston University. She has done both policy and clinical research at Brigham and Women’s Hospital (WHARP), IHRSA, and Mathematica. 
For the past six and a half years, she was part of the Clinical Trials Office through the Urology Department at Michigan Medicine where she coordinated studies, designed/maintained databases, and performed statistical analysis on occasion. Most of her work involved Neurogenic Bladder research. She also served as the Program Manager for NBRG (Neurogenic Bladder Research Group) for the past two years. 
MPOG Outcomes Research Fellows
In January of this year, we introduced our inaugural Outcomes Research Fellowship. 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 experts across MPOG national network. We are pleased to welcome our first two research fellows, Dr. Clark Fisher from Yale School of Medicine, and Dr. Sunny Lou from Washington University, St. Louis, see our website for their bios and to learn a little about their fellowship projects.  
Clark Fisher, MD, PhD
Yale University
Sunny Lou, MD, PhD
Washington University
Recent Publications
Measure Updates
SUS-02: New sustainability measure released! SUS-02 calculates the global warming potential (GWP) for the maintenance phase of anesthesia reported as percentage of cases where carbon dioxide (CO2) equivalents normalized by hour is less than CO2 equivalents of 2% sevoflurane at 2 L/min fresh gas flow. See measure specification for more details.
SUS-3 (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. 

SUS-04: New sustainability metric that mirrors SUS-01 (FGF < 3L/min), but with a higher bar. Percentage of cases using halogenated agents or nitrous oxide that have a mean fresh gas flow of less than 2 L/min. See measure specification for more details.

BP-05 (PENDING): New hypotension measure reporting the percentage of adult cases where severe hypotension during anesthesia induction (defined as MAP < 55mmHg) was avoided. 
GLU-03: Updated this hyperglycemia management measure to now consider subcutaneous insulin dosing. If insulin SQ was administered within 120 minutes before the high glucose value, that value will now be excluded. See measure specification for more details
GLU-05: Updated the hyperglycemia treatment measure to now assess if subcutaneous insulin was administered. If insulin SQ was given within 180 minutes before the high glucose value was documented, that value will now be excluded. See measure specification for more details.

NMB-03-Peds: New measure focusing on NMB dosing in patients less than five years old. Percentage of pediatric cases that receive appropriate initial dosing of non-depolarizing neuromuscular blocking drugs intraoperatively. See measure specification for more details.
SMOK-01: First of two measures created for Michigan sites participating in the Blue Cross Blue Shield of Michigan (BCBSM) Value-Based Reimbursement program. This measure evaluates smoking status documentation within 30-days prior to surgery. See measure specification for more details.
SMOK-02: Smoking cessation measure examining the percentage of cases documented as current smoker and receiving smoking cessation intervention from an anesthesia provider. See measure specification for more details.
Quality Subcommittees
The Cardiac Subcommittee met in April with 20 participants in attendance. The committee reviewed blinded performance for the new hyperthermia avoidance measure (TEMP-07) and voted to report TEMP-07 as an inverse measure (lower performance is desired). The group also voted to pursue development of a cardiac-specific hyperglycemia avoidance measure. Cardiac anesthesiologists are beginning to discuss ASPIRE cardiac measures with their perfusionist colleagues. 
As these conversations continue, we hope more perfusionists will join the Perfusionist Workgroup to provide input for future measures. If interested in learning more, please contact Dr. Allison Janda, chair of the MPOG Cardiac Anesthesia Subcommittee and the Perfusionist Workgroup.

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 August.

There was no obstetrics subcommittee meeting since last newsletter. The next subcommittee will be held on August 3, 2022. If you are interested in participating or have any questions, please contact us
The Pediatrics Subcommittee met on May 18, 2022. The MPOG sustainability metrics were reviewed, and the subcommittee members discussed whether these metrics were applicable to the pediatric population. Our May Meeting Notes can be found here. Two new sustainability measures were proposed by the MPOG Peds sustainability workgroup (which also met in May) and will be voted on at the next meeting
  • SUS-05-Peds: Weight-based fresh gas flow during induction
  • SUS-06-Peds: Nitrous used during induction 

Unblinded performance data was also reviewed across MPOG Pediatric sites with a focus on normothermia measures (TEMP-03, TEMP-04-Peds). Additional performance measures will be unblinded at the next subcommittee meeting on August 17, 2022.

If you are interested in participating in this subcommittee or any of the MPOG pediatric workgroups, please contact Meridith Bailey for more information. 
Technical Updates
The MPOG Technical team completed their Spring upgrade in May, see our website for the release notes. The next upgrade is scheduled for October 2022.
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