Dear MPOG Community,

We are excited to share our Winter 2024 Newsletter. The past few months have been a busy time within MPOG, we have welcomed new hospitals, announced our new MPOG fellows for 2024/25, have multiple updates to quality measures, growing activity, and new faces in the quality subcommittees. While we can’t cover everything, please read some of our updates below. 

We would highlight a particularly successful fall with the launch of the full scale of THRIVE and tremendous interest in the IMPACT pragmatic trial award. We will be sharing more of this in coming months.  

MPOG’s work is grounded in our partnerships across institutions to improve perioperative care. We thank you for your ongoing commitment to this community and are excited for the year ahead. 

Best Wishes, 

Douglas Colquhoun, MBChB, MSc, MPH

Associate Research Director, MPOG

MPOG welcomes the University of Nebraska as our newest MPOG site! Read more about Nebraska Medicine.

Rounding out 2023, we were delighted to have Dr. Brad Taicher from Duke Health as our featured member for November and December. Dr. Taicher served as the Chair of the Pediatric Subcommittee, is the Quality Champion at Duke, and he's collaborating with multiple institutions on PCRCs on both healthcare disparities and PONV.



Kicking off 2024, we are excited to feature Denise Schwerin, RN from Bronson Healthcare. She serves as the Anesthesiology Clinical Quality Reviewer (ACQR) and works closely with the Quality Champion using MPOG data to improve patient care.

Read more about them on our Featured Member page.



Since our last newsletter, THRIVE has launched at 6 more sites and enrolled over 300 patients! We are thrilled by the progress and rapid pace of recruitment. This has been a huge effort from many teams and we are thankful for their participation. The pace of participant enrollment will continue to increase as we bring all sites online through the summer. In the regular active site meetings, we have been sharing best practices and learning from each other to continue the successful trial roll out.  

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! 

Sugammadex was initially approved for reversal of neuromuscular blockade in adults in the United States in 2015. Limited data suggest sugammadex is widely used in pediatric anesthesia practice however the factors influencing use are not known. We explore patient, surgical, and institutional factors associated with the decision to use sugammadex versus neostigmine or no reversal, and the decision to use 2 mg/kg vs 4 mg/kg dosing.



Brown SES, et al. Factors Associated with Decision to Use and Dosing of Sugammadex in Children: A Retrospective Cross-Sectional Observational Study. Anes Analg. 2024 Jan 19. Online ahead of print.  

BRAIN-01: New brain health measure identifying the percentage of patients > 70 years old who received a benzodiazepine perioperatively. Results are inversely reported (lower is better). This measure is informational only and does not have a threshold for target performance. The goal of this measure is to highlight variation in practice and may be an opportunity for future research using MPOG data. 

NMB-04: Recently released sugammadex dosing measure that examines the percentage of adult and pediatric (> 3 years) cases with a cumulative sugammadex dose < 200 mg OR < 3 mg/kg. Practice leaders may be interested in performance on this metric to understand variation in single 200 mg vial use and dosing patterns. This measure also encourages judicious use of neuromuscular blockade (NMB), encouraging train-of-four values of at least 2 before reversing with sugammadex. This measure is available for provider feedback emails.  

ABX-02-C: The antibiotic timing measure for open cardiac procedures is now available on the ‘All Measures’ and ‘Cardiac Anesthesia’ dashboards within the QI Reporting Tool. This measure was developed with the support of the MPOG Cardiac Anesthesia Subcommittee and specifically focuses on the timing of prophylactic antimicrobial administration before surgical incision.

ABX-03-C: The second of four antibiotic compliance measures for cardiac surgery that are scheduled to be released this year. ABX-03-C measures the percentage of patients undergoing open cardiac surgery with an antibiotic redose initiated within four hours after initial antibiotic administration (cephalosporins only). This measure is available on the ‘All Measures’ and ‘Cardiac Anesthesia’ dashboards within the QI Reporting Tool.

Flowcharts are now available for most measures on the MPOG Measure Specification page. Measure logic can be difficult to understand. Our hope is that the flowcharts will enable Quality Champions and ACQRs to interpret measure criteria more easily. Please submit all feedback and questions to support@mpog.zendesk.com.  

Several new updates and bug fixes have been applied to the QI Dashboard to improve the user experience. The provider measure summary page now includes a case list section, result reasons breakdown graph, and provider benchmarking graph. In this anonymized visualization, providers can view their performance compared to others within the same role at their institution. Detailed information regarding these updates can be found under release notes on the MPOG website and are updated monthly. 

Please contact support@mpog.zendesk.com with questions or feedback regarding this tool. 

The Cardiac Anesthesia Subcommittee last met in December. The group reviewed the proposed antibiotic administration for open cardiac procedure measure specifications (timing, re-dosing, selection, and overall composite). Preliminary data was shared for the timing and re-dosing measures and the subcommittee decided to move forward with building all four measures.  Since the meeting, ABX-02-C (timing) and ABX-03-C (re-dosing) measures have been released (see Measure Updates section of the newsletter for more information). Special thanks to the subcommittee members who participated in the unblinded performance review for the glycemic management measures (GLU-06-C, GLU-07-C, and GLU-08-C). The review led to excellent discussion during the meeting that we hope will continue to fuel conversations within local departments. The Cardiac Subcommittee meeting minutes are available for those who were unable to attend.    

The next meeting will be in April, though the date and time are yet to be determined. More information will be posted to the Cardiac Anesthesia Subcommittee forum as it becomes available. Please contact Dr. Allison Janda if interested in participating! 

Congratulations to Dr. Brandon Togioka (Oregon Health and Science University), our new MPOG Obstetric Anesthesia Subcommittee Chair! Thank you to Dr. Monica Servin for leading the subcommittee for the last 2 years.

The OB Subcommittee last met February 7; minutes can be found on our archived events page. Dr. Brendan Carvalho, MD from Stanford Hospital and Past President of the Society for Obstetric Anesthesia and Perinatology (SOAP) presented information about the Center of Excellence (COE) site designation program. Thank you for the presentation and lively discussion. Drs. Sharon Abramowitz (Weill Cornell Medical College) and Melinda Mitchell (Henry Ford Health) reviewed the General Anesthesia during Cesarean deliveries and General Anesthesia after Neuraxial in Cesarean Deliveries (GA-01 and GA-02) measures. The subcommittee voted to continue both measures as is. 

We are excited to see continued interest in the subcommittee and look forward to meeting again on Wednesday, May 22, 2024, at 1pm EST. The OB Subcommittee is open to all providers interested in improving OB anesthesia care. Please contact Nicole Barrios if interested in joining.  

MPOG is pleased to announce Dr. Vikas O’Reilly-Shah (Seattle Children’s) as the new Chair and Dr. Morgan Brown (Boston Children’s) as Vice-Chair of the pediatric subcommittee. Dr. O’Reilly-Shah previously served as vice chair with Dr. Brad Taicher (Duke Children’s). We would like to thank Dr. Taicher for his many contributions over the past year in this role and for his continued participation as a member of the MPOG pediatric subcommittee.

At our last meeting on December 4, 2023, Dr. Lisa Einhorn (Duke University) reviewed the pediatric multimodal analgesia measure PAIN-01-Peds. The Subcommittee voted to modify this measure to exclude cases that received no analgesia, exclude block only cases, and to add a performance threshold of 90%. These modifications have been implemented and updated scores can be found on your site’s quality dashboard.  

This year we are also forming a cardiac interest group within the pediatric subcommittee led by Dr. Morgan Brown. Our first meeting is February 13, 2024 at 4pm ET. The goals of this workgroup are to collaborate on a cardiac procedure phenotype specific to pediatrics, discuss projects of interest and future data merge opportunities between MPOG and the Congenital Cardiac Anesthesia Society (CCAS). 

Our next general Pediatric Subcommittee meeting will be held in March 2024. This committee is open to all providers interested in improving pediatric anesthesia care. Please contact Meridith Wade if interested in joining the subcommittee.