AQI72 Perioperative Anemia Management

Measure ID

AQI72

Measure Title

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.

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

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.

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 less than 13 gm/dL all adults regardless of gender.

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.

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.

Denominator Exceptions

Negative preoperative anemia screening result
OR
Documentation of medical or patient reason(s) for not screening for anemia and/or using selected management strategies (e.g., patient refusal, contraindication, etc.)

Numerator Exclusions

None

NQF ID

N/A

NQS Domain

Patient Safety

High Priority Measure

Yes

High Priority Type

Patient Safety

Measure Type

Process

Telehealth

No

Meaningful Measure Area

Preventable Healthcare Harm

Inverse Measure

No

Proportional Measure

Yes

Continuous Variable Measure

No

Ratio Measure

No

Range of the score(s) if Continuous Variable and/or Ratio

N/A

Number of performance rates to be calculated and submitted

1

Performance Rate Description(s)

This measure consists of a single performance rate that describes the percentage of patients tested preoperatively for anemia who, when indicated, received appropriate preoperative and intraoperative management strategies.

Overall Performance Rate

1st Performance Rate

Risk-Adjusted Status

No

Risk-Adjusted Score

N/A

Care Setting

Hospital

Additional Care Setting Information

N/A