Transcript Knowledge is Power” - AQI - Anesthesia Quality Institute

“Knowledge is Power”
-- Sir Francis Bacon, 1597
AQI Reporting:
Participant Webinar
Learning Objectives
• Update participants on AQI status
• Demonstrate new features of the AQI
reports
• Discuss future directions and solicit
opinions
The
Challenge
The government
wants to know
that Ma and Pa
are getting the
healthcare they
deserve … and
that our taxes
pay for.
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We live in the Information Age…
“Your data is going to be collected. Do
you want it to be gathered by your
friends or by your enemies?”
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-- Keith Ruskin, MD
* Goofy picture of Keith obtained in
5.4 seconds of internet search.
The AQI
• A non-profit 501(c)3 corporation
• Vision: To become the primary source for
quality improvement in the clinical practice of
anesthesiology
• Goal: To establish and maintain the National
Anesthesia Clinical Outcomes Registry
AQI Registries
• NACOR
• AIRS
• PPAI
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NACOR: the National Anesthesia
Clinical Outcomes Registry
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Electronic capture
All cases (no bias)
All available data
De-identified, but with context
Automated reporting
Automated validation
Analysis and reporting
NACOR to date
• > 800 interested groups
• 160 participating practices
• Case data from:
– 100 groups
– 1100 facilities
– 8,500 providers
–4,500,000 cases
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Demographics
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40,000 ORs in 5,000 hospitals in the US
+ Surgicenters, clinics, doctors offices, etc.
75 million procedures?
30-40m major anesthetics?
60% of surgery on an outpatient basis
60% of hospital $$ are surgery-related
3% annual growth in volume since 1990
Providers
• 45,000 anesthesiologists
– Median age 50
– Working 50 hours/wk
– 25% female, but rising fast
• 45,000 nurse anesthetists
• 2,000 anesthesiologist assistants
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The “Average” Practice
• 36 anesthesiologists
• 20 nurse anesthetists
• Working in 9 facilities
• 92% are ASA members
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Top 20 Cases in NACOR
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Cataract
Lap. cholecystectomy
ECT
Total knee arthroplasty
PE Tubes
Knee arthroscopy
Upper endoscopy
Lower endoscopy
Tonsillectomy
Cesarean section
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Lap. appendectomy
Total hip arthropasty
Adult inguinal hernia
Hysteroscopy
Carpal tunnel repair
Oral surgery
Shoulder arthroscopy
Lumbar laminectomy
Lithotripsy
Hardware removal
Top 5 “Non-Cases” in NACOR
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Labor analgesia
Placement of arterial catheter
Central line placement
Brachial plexus injection
Femoral nerve injection
Top 5 “Non-Cases” in NACOR
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Labor analgesia
Placement of arterial catheter
Central line placement
Brachial plexus injection
Femoral nerve injection
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Number of Cases
Patient Age
40,000
35,000
30,000
25,000
20,000
15,000
10,000
5,000
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Age
Age and ASA Physical Status
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Patient Age
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Gender Distribution
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Surgical Procedures: Age and
Gender
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Anesthesia Type
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Outcomes
Measure
Group
Description (n=814,890 cases)
Process
Process outcomes
Major
Serious adverse events; actual patient harm or significant risk
Minor
Events
Incident
Rate
11,201
1.37%
3,539
0.43%
Minor adverse event; without long-term impact
85,210
10.46%
Admin
Administrative outcomes; such as case cancel, extended PACU, unexpected admission
11,420
1.40%
Mortality
Patient death; excluding patients presenting for organ harvesting
293
0.04%
AQI REPORTS
How To
22 May 2012
Login @ http://aqihq.org/
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After Login
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AQI Practice Reports
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Reporting Categories
• Practice
– Providers, Age, Gender, FTE, LOS, ASA
Membership
• Patients
– Age, Gender, ASA PS, Location
• Cases
– Duration, Facilities, Provider, CPT
• Outcomes
– National, Practice, Provider, Facility, PONV
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Practice Reports
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Provider Distribution
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Patients – Age, Gender, ASA PS,
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Location
Patient Gender by Age
Patient - Gender
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Cases
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Cases - Providers
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Age and ASA PS
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Procedure Duration
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Filters
• Select Criteria for Filter
– CPT
– Month
– ASA Class
– Facility Type
– Age Category
– Anesthesia Type
• Click View Report
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Outcomes
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Outcomes - National
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Minor Events
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Summary
• AQI has 4.5 M cases
– 1M+ with quality measures
• AQI is looking to help with your reporting
needs:
– Hospital Administration
– MOCA
– OPPE / FPPE
– Joint Commission
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Have I forgotten anything?