Measure ID

Percentage of cases where blood pressure monitoring gaps greater than 10 minutes were avoided.

Measure Type
Available for Provider Feedback

The American Society of Anesthesiologist (ASA) standards for basic anesthetic monitoring includes an evaluation of blood pressure at least every five minutes in an effort to ensure adequate circulatory function during anesthesia. A retrospective study including 130,000 general anesthesia cases confirmed that blood pressure gaps greater than six and ten minutes are associated with a higher incidence of a patient transitioning into hypotension, leading to an increased risk of developing kidney or myocardial injury postoperatively. Extenuating circumstances where BP is not quantitatively measured every five minutes should be documented in the patient’s medical record.1-3 

Hypotension is strongly associated with mortality, acute kidney injury, and myocardial ischemia.  The avoidance of hypotension requires the timely and frequent measurement of blood pressure.

Measure Time Period

Anesthesia Start to Anesthesia End (See 'Other Measure Build Details' for more information.)


Adult patients requiring anesthesia

Success Criteria

Blood pressure monitoring with ≤10-minute gap in measurement interval.

Other Measure Details

A measurement gap will be recorded for cases that have greater than ten minutes between consecutive blood pressure readings. The measure will capture non-invasive and invasive BP measurements.

Algorithm for determining Measure Start/End Times: 

Measure Start:

First Blood Pressure Reading after the latest of these 3 times:

  1. First documented Anesthesia Start time.
  2. First documented Patient in Room time.
  3. First documented Data Capture Start time.

For cesarean delivery cases converted from labor epidural (as determined by Obstetric Anesthesia Type value code:1): Cesarean Delivery Start Time is used as the 'Measure Start Time'.

Measure End: Anesthesia End

*This measure will include valid MPOG cases defined by the Is Valid Case phenotype.

Risk Adjustment

Not applicable

Provider Attribution

Provider(s) signed into the case at the 11th minute of identified measurement gap. Providers signed in for ≤ 10 minutes from the measure start time will be excluded.

MPOG Concept Used
  • 3011       BP Sys Invasive Unspecified Site 1
  • 3012       BP Dias Invasive Unspecified Site 1
  • 3013       BP Mean Invasive Unspecified Site 1
  • 3015       BP Sys Non-invasive
  • 3020       BP Dias Non-invasive
  • 3025       BP Mean Non-invasive
  • 3026       BP Sys Invasive Unspecified Site 4
  • 3027       BP Dias Invasive Unspecified Site 4
  • 3028       BP Mean Invasive Unspecified Site 4
  • 3030       BP Sys Arterial Line (Invasive, Peripheral)
  • 3035       BP Dias Arterial Line (Invasive, Peripheral)
  • 3040       BP Mean Arterial Line (Invasive, Peripheral)
  • 3041       BP Sys Invasive Unspecified Site 2
  • 3042       BP Dias Invasive Unspecified Site 2
  • 3043       BP Mean Invasive Unspecified Site 2
  • 3046       BP Sys Invasive Unspecified Site 3
  • 3047       BP Dias Invasive Unspecified Site 3
  • 3048       BP Mean Invasive Unspecified Site 3
  • 3475       BP Sys Invasive Unspecified Site 5
  • 3476       BP Dias Invasive Unspecified Site 5
  • 3477       BP Mean Invasive Unspecified Site 5
  • 3041       BP Sys Invasive Unspecified Site 2
MPOG Phenotypes Used
  1. Standards and Practice Parameters Committee. (2012). American Society of Anesthesiologists. Standards for basic anesthetic monitoring.
  2. Kruger GH, Shanks A, Kheterpal S, et al. Influence of non-invasive blood pressure measurement intervals on the occurrence of intra-operative hypotension. Journal of clinical monitoring and computing. 2018;32(4):699-705.
  3. Anesthesiologists. ASo. Standards for basic anesthetic monitoring. In: Anesthesiologists ASo, ed. Vol 4.2.22015.
  4. Bartels K, Esper SA, Thiele RH. Blood Pressure Monitoring for the Anesthesiologist: A Practical Review. Anesthesia and analgesia. 2016;122(6):1866-1879.
Measure Authors
 Measure Author  Institution
 Nirav Shah, MD  University of Michigan
 Sachin Kheterpal, MD, MBA  University of Michigan
 Jamie Osborne, RN  University of Michigan
 Mark Dehring  University of Michigan
 MPOG Quality Committee  


Measure Reviewer(s)
Next Review: 2025
 Date Reviewed   Reviewer  Institution  Summary   QC Vote 
 11/28/2022  Marc Pimental, MD  Brigham & Women's Hospital  Review   Modify


Published: 2015
Date  Criteria Revision
6/21/2021 Exclusion  Modified OB exclusion to use Obstetric Anesthesia Type phenotype
11/1/2015   Initial Publication