1. “Knowledge is Power”
-- Sir Francis Bacon, 1597

2. AQI Reporting: Participant Webinar

3. Learning Objectives Update participants on AQI status
Demonstrate new features of the AQI reports
Discuss future directions and solicit opinions

4. The
Challenge
The government wants to know that Ma and Pa are getting the healthcare they deserve … and that our taxes pay for.
11/8/2018

5. 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?” *
-- Keith Ruskin, MD
* Goofy picture of Keith obtained in 5.4 seconds of internet search.

6. 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

7. AQI Registries
NACOR
AIRS
PPAI
11/8/2018

8. NACOR: the National Anesthesia Clinical Outcomes Registry
Electronic capture
All cases (no bias)
All available data
De-identified, but with context
Automated reporting
Automated validation
Analysis and reporting

9. NACOR to date 4,500,000 cases > 800 interested groups
160 participating practices
Case data from:
100 groups
1100 facilities
8,500 providers
4,500,000 cases
11/8/2018

10. 11/8/2018

11. Demographics 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
11/8/2018

12. Providers 45,000 anesthesiologists 45,000 nurse anesthetists
Median age 50
Working 50 hours/wk
25% female, but rising fast
45,000 nurse anesthetists
2,000 anesthesiologist assistants
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13. The “Average” Practice
36 anesthesiologists
20 nurse anesthetists
Working in 9 facilities
92% are ASA members

15. 11/8/2018

16. Top 20 Cases in NACOR Cataract Lap. appendectomy Lap. cholecystectomy
Total knee arthroplasty
PE Tubes
Knee arthroscopy
Upper endoscopy
Lower endoscopy
Tonsillectomy
Cesarean section
Lap. appendectomy
Total hip arthropasty
Adult inguinal hernia
Hysteroscopy
Carpal tunnel repair
Oral surgery
Shoulder arthroscopy
Lumbar laminectomy
Lithotripsy
Hardware removal
11/8/2018

17. Top 5 “Non-Cases” in NACOR
Labor analgesia
Placement of arterial catheter
Central line placement
Brachial plexus injection
Femoral nerve injection

18. Top 5 “Non-Cases” in NACOR
Labor analgesia
Placement of arterial catheter
Central line placement
Brachial plexus injection
Femoral nerve injection

19. Patient Age

20. Age and ASA Physical Status
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21. Patient Age
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22. Gender Distribution
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23. 11/8/2018

24. Surgical Procedures: Age and Gender
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25. Anesthesia Type
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26. Outcomes Measure Group Description (n=814,890 cases) Events
Incident Rate
Process
Process outcomes
11,201
1.37%
Major
Serious adverse events; actual patient harm or significant risk
3,539
0.43%
Minor
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%

27. AQI REPORTS How To
22 May 2012

28. Login @ http://aqihq.org/
11/8/2018

29. After Login
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30. AQI Practice Reports
11/8/2018

31. Reporting Categories Practice Patients Cases Outcomes
Providers, Age, Gender, FTE, LOS, ASA Membership
Patients
Age, Gender, ASA PS, Location
Cases
Duration, Facilities, Provider, CPT
Outcomes
National, Practice, Provider, Facility, PONV
11/8/2018

32. Practice Reports
11/8/2018

33. Provider Distribution
11/8/2018

34. Patients – Age, Gender, ASA PS, Location
11/8/2018

35. Patient Gender by Age Patient - Gender
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36. Cases
11/8/2018

37. Cases - Providers
11/8/2018

38. Age and ASA PS
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39. Procedure Duration
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40. Filters Select Criteria for Filter Click View Report CPT Month
ASA Class
Facility Type
Age Category
Anesthesia Type
Click View Report
11/8/2018

41. Outcomes
11/8/2018

42. Outcomes - National
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43. Minor Events
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44. 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
11/8/2018

45. Have I forgotten anything?