Percentage of patients with active warming applied.
General and neuraxial anesthesia causes vasodilation thus redistributing body heat from the core to peripheries. This redistribution can cause hypothermia. Core temperatures outside the normal range pose significant risks to patients. Pediatric patients are more likely to develop perioperative hypothermia due to a high surface area to weight ratio and inability to regulate their own temperature.1 Published research has correlated impaired wound healing, adverse cardiac events, altered drug metabolism, and coagulopathies with unplanned perioperative hypothermia. These adverse outcomes resulted in prolonged hospital stays and increased healthcare expenditures. Active warming techniques provide the best results for reducing cutaneous heat loss and preventing hypothermia.2-7
The active warming (TEMP 01) measure will identify the percentage of cases in which an active warming device was applied between 'Case Start' and 'Case End' or the patient maintained a temperature above 36.0°C without active warming. In the event that active warming was not performed or documented, the case will meet the measure requirements if at least one temperature is greater than or equal to 36.0°C within 30 minutes of patient out of room.
Active warming is determined by Warming Method Classification value codes: 2, 4, 5, 96.
Active Warming includes:
Passive Warming interventions (NOT active warming):
Algorithm for determining Case Duration for Exclusion Criteria (<60 minutes):
Algorithm for determining Case End for 36.0°C Success Criterion:
Temperature Artifact algorithm:
*This measure will include only valid MPOG cases as defined by the Is Valid Case phenotype.
|Nirav Shah, MD||University of Michigan|
|Jaime Osborne, RN||University of Michigan|
|Kate Buehler, MS, RN||University of Michigan|
|Meridith Wade, MSN, RN||University of Michigan|
|Jay Jeong||University of Michigan|
|Sachin Kheterpal, MD||University of Michigan|
|MPOG Quality Committee|
|Date Reviewed||Reviewer||Institution||Summary||QC Vote|
Sunny Chiao, MD
Aisha Qazi, MD
University of Virginia
Corewell East - Troy
Modified case end algorithm updated to use latest time for extubation/LMA removal.
Removed MRI exclusion
Added Diagnostic Imaging exclusion
Exclusion: Case duration algorithm updated
Success: Updated end time from Case End phenotype to Patient out of room
|Exclusion||Modified to use Obstetric Anesthesia Technique phenotype; Cases now invalid if case end < case start|
|12/2/2019||Exclusion||Modified to use Anesthesia CPTs for Measures phenotype instead of Primary Anesthesia CPT phenotype|