2021 AQI72: Perioperative Anemia Management

Measure Description

Percentage of patients, aged 18 years and older, undergoing elective total joint arthroplasty who were screened for anemia preoperatively AND, if positive, have documentation that one or more of the following management strategies were used prior to PACU discharge.

Denominator

Patients, aged 18 years and older, undergoing elective total joint arthroplasty.

Denominator Note: For the purpose of this measure, total joint arthroplasty includes arthroplasty of the knee, hip, and shoulder.

Denominator Criteria (Eligible Cases):
All patients, aged 18 years and older
AND
Elective Surgery: G9643
AND
Patient encounter during the reporting period (CPT): 01214, 01215, 01402, 01638

Denominator Exclusions
Surgeon or other non-anesthesia professional clinician completed one or more of the management strategies without direction or assistance from the anesthesia professional.

Numerator

Patients who were screened for anemia preoperatively AND, if positive, have documentation that one or more of the following management strategies were used prior to PACU discharge.

Management strategies include one or more of the following:

• Cell salvage techniques employed intraoperatively
• Intraoperative antifibrinolytic therapy or tourniquet, if not contraindicated
• Preoperative iron supplementation, epoetin alpha
• Use of evidence-based preoperative anemia management algorithm supplemented with laboratory testing and/or multidisciplinary consult

Numerator definition: For the purpose of this measure, a positive preoperative anemia screening result is defined as a Hgb value <13 gm/dL for men or Hgb value <12 gm/dL for women

Numerator note: Preoperative screening for anemia could include any of the following tests: complete blood count (CBC), arterial blood gas (ABG), venous blood gas (VBG), or other point of care hemoglobin/hematocrit test within 90 days and until one day prior to the surgical procedure.

Numerator Quality-Data Coding Options for Reporting Satisfactorily
Performance Met:
11A67 Patient was screened for anemia preoperatively AND documentation of one or more selected management strategies used prior to PACU discharge.
OR
Denominator Exception:
11A68 Negative preoperative anemia screening result.
OR
Denominator Exception:
11A69 Documentation of medical or patient reason(s) for not screening for anemia and/or using selected management strategies (e.g., Jehovah’s witness,
patient refusal, contraindication, etc).
OR
Performance Not Met:
11A70 No preoperative patient screen for anemia OR positive preoperative anemia screening result and no documentation of one or more selected management strategies used prior to PACU discharge.

Numerator Exclusions

None

NQF ID Number

N/A

NQS Domain

Patient Safety

High Priority Measure

Yes

Includes Telehealth?

No

Inverse Measure

No

Proportional Measure

Yes

Continuous Variable Measure

No

Ratio Measure

No

Number of performance rates to be calculated and submitted

1

Risk-Adjusted Status?

No