“Knowledge is Power”

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.

5. We live in the Information Age… * -- Keith Ruskin, MD * Goofy picture of Keith obtained in 5.4 seconds of internet search. “Your data is going to be collected. Do you want it to be gathered by your friends or by your enemies?”

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

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 • > 800 interested groups • 160 participating practices • Case data from: • 100 groups • 1100 facilities • 8,500 providers • 4,500,000 cases

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

12. Providers • 45,000 anesthesiologists • Median age 50 • Working 50 hours/wk • 25% female, but rising fast • 45,000 nurse anesthetists • 2,000 anesthesiologist assistants

13. The “Average” Practice 36 anesthesiologists 20 nurse anesthetists Working in 9 facilities 92% are ASA members

16. Top 20 Cases in NACOR • Cataract • Lap. cholecystectomy • ECT • 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

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

21. Patient Age

22. Gender Distribution

24. Surgical Procedures: Age and Gender

25. Anesthesia Type

26. Outcomes

27. AQI REPORTSHow To 22 May 2012

28. Login @ http://aqihq.org/

29. After Login

30. AQI Practice Reports

31. 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

32. Practice Reports

33. Provider Distribution

34. Patients – Age, Gender, ASA PS, Location

35. Patient Gender by AgePatient - Gender

36. Cases

37. Cases - Providers

38. Age and ASA PS

39. Procedure Duration

40. Filters • Select Criteria for Filter • CPT • Month • ASA Class • Facility Type • Age Category • Anesthesia Type • Click View Report

41. Outcomes

42. Outcomes - National

43. Minor Events

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

45. Have I forgotten anything?