Concern for the quality of healthcare delivery is important to both the healthcare industry and the general public. This concern is especially high in surgical environments, as surgical errors can result in serious complications [2]. In order to meet expectations, medical professionals now focus on creating and adhering to healthcare quality measures. Quality measures, such as the ASA Quality Measures, help healthcare professionals gather the data needed to understand healthcare treatment, patient outcomes, and patient perceptions in order to improve the quality of care that is being provided to patients [4].  

The goal of implementing quality measures is to provide more safe, efficient, and “patient-centered” care [4]. The Department of Health and Human Services (HHS) has made quality healthcare a key goal, and the Centers for Medicare & Medicaid Services (CMS) work with physicians and healthcare groups, such as the American Society of Anesthesiologists (ASA), to track the quality of care. This is done through the Qualified Clinical Data Registry (QCDR), which collects and analyzes data from physicians about their treatment of patients to set national standards [1].  

The ASA Department of Quality and Regulatory Affairs (QRA) spearheads efforts to improve their own quality measures. Through 2019 and 2020, the QRA team worked with the ASA Committee on Performance Outcomes and Measurement (CPOM) and the Core Measure Development Group (CMDG) to develop new quality measures for anesthesiology, which will be added to the Anesthesia Quality Institute National Anesthesia Clinical Outcomes Registry in 2021. These measures include the “prevention of arterial line-related bloodstream infections, intraoperative antibiotic redosing, perioperative anemia management, and ambulatory glucose management.” [3] 

The arterial line-related bloodstream infections measure focuses on the number of patients who receive peripheral intra-arterial catheters with a sterile technique and creates standards to improve the safety of such procedures [3]. The intraoperative antibiotic redosing measure aims to improve safety for procedures that take over two hours and require preoperative antibiotic prophylaxis during the sixty minutes before incision [3]. The perioperative anemia management measure encourages anesthesiologists to discuss anemia management strategies with relevant patients, among other goals [3]. The ambulatory glucose management measure studies diabetic patients who are treated in an “office-based or outpatient setting,” ensuring that their blood glucose level is maintained at acceptable levels, thereby preventing postoperative infections and delayed wound healing [3]. 

The ASA developed these measures during the 2019-2020 cycle through an intense process that included analyzing measures from previous years, receiving feedback from medical professionals, amending drafts, and ultimately publishing their final report.  

Every year, the CMS releases new quality measures for inclusion into the QCDR, a process that typically takes 9-12 months [3]. This year, the CMS is requiring higher standards of testing and research in order for new measures to be included in the QCDR, which delays the final quality measures from being released [3]. This delay gives the ASA an extra opportunity to prepare, but the new standards also increase the challenge of including the ASA quality measures into the QCDR.  

Healthcare quality measures are essential in protecting patients and holding healthcare professionals accountable. The CMS, QCDR, and groups like the ASA will continue working to improve patient care. 

References 

[1] “About ASA.” About ASA | American Society of Anesthesiologists (ASA), www.asahq.org/about-asa.  

[2] Chun, Jonathan, and Andrea Bafford. “History and Background of Quality Measurement.” Clinics in Colon and Rectal Surgery, vol. 27, no. 01, 2014, pp. 005–009., doi:10.1055/s-0034-1366912.  

[3] Ostarello, Claire, et al. “New Quality Measures, New Opportunities for Reporting in 2021.” ASA Monitor, American Society of Anesthesiologists, 1 July 2020, pubs.asahq.org/monitor/article-abstract/84/7/15/109331/New-Quality-Measures-New-Opportunities-for.  

[4] “Quality Measures.” CMS, www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures.