ASPIRE Measures

Current Performance Measures

Measure

Description

One Pager
Providers
Documents

Specification
Technical
Documents

AKI 01: Acute Kidney Injury

Percentage of cases that the baseline creatinine does not increase more than 1.5 times within 7 days post-op or the baseline creatinine level does not increase by ≥ 0.3 mg/dL within 48 hours post-op.

AKI 01 One Pager AKI 01 Specification

BP 01: Low MAP Prevention

Percentage of unique case-staff instances that sustained intraoperative hypotension was avoided. 

BP 01 One Pager

BP 01 Specification

BP 02: Avoiding Monitoring Gaps

Percentage of unique case-staff instances that avoid long gaps in blood pressure management.

BP 02 One Pager

BP 02 Specification

CARD 01: Avoiding MI

Percentage of cases without elevated Troponin I levels (>1.00) postoperatively. 

CARD 01 One Pager

CARD 01 Specification

FLUID -01-C: Minimizing Colloid Use- Cardiac

Colloid use limited in cardiac cases with no indication

FLUID 01-C One Pager

FLUID 01-C Specification

FLUID 01-NC: Minimizing Colloid Use- Non-Cardiac

Colloid use limited in non-cardiac cases with no indication FLUID 01-NC One Pager FLUID 01-NC Specification

GLU 01: High Glucose Treated

Percentage of cases with perioperative glucose > 200 (between anesthesia start-2 hours and anesthesia end)  administration of an insulin bolus or infusion or glucose test recheck

GLU 01 One Pager

GLU 01 Specification

GLU 02: Low Glucose Treated

Percentage of cases with glucose < 60 (between anesthesia start-2 hours and anesthesia end) with a glucose test recheck or administration of dextrose containing solution   (between anesthesia start and anesthesia end + 2 hours)

GLU 02 One Pager

GLU 02 Specification

MED 01: Avoiding Medication Overdose

Percentage of cases that avoided medication overdose and use of nalaxone or flumazenil for cases that opioids or benzodiazepines were administered.

MED 01 One Pager

MED 01 Specification

NMB 01: Train of Four Taken

Percentage of cases receiving a non-depolarizing neuromuscular blocker that have a TOF monitor documented

NMB 01 One Pager

NMB 01 Specification

NMB 02: Reversal Administered

Percentage of cases receiving a non-depolarizing neuromuscular blockade medication with administration of neostigmine if time from last non- depolarizer administration to extubation is < 4 hours

NMB 02 One Pager

NMB 02 Specification
PONV 01: Postoperative Nausea and Vomiting Percentage of patients, aged 18 years and older, who undergo a procedure under an inhalational general anesthetic, AND who have three or more risk factors for post-operative nausea and vomiting (PONV), who receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively or intraoperatively. PONV 01 One Pager PONV 01 Specification

PUL 01: Low Tidal Volume

Percentage of cases with median tidal volumes less than 10 ml/kg

PUL 01 One Pager

PUL 01 Specification

TEMP 01: Active Warming

Percentage of cases with increased risk of hypothermia that active warming was administered by the anesthesia provider

TEMP 01 One Pager

TEMP 01 Specification

TEMP 02: Core Temperature Measurement

Percentage of cases with increased risk of hypothermia that the anesthesia provider documented a core or near-core temperature
 
TEMP 02 One Pager TEMP 02 Specification
TEMP 03 (MIPS 424): Perioperative Temperature Management

Percentage of patients, regardless of age, who undergo surgical or therapeutic procedures under general or neuraxial anesthesia of 60 minutes duration or longer for whom at least one body temperature greater than or equal to 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) was recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time

TEMP 03 One Pager

TEMP 03 Specification

TOC 02       (MIPS 426): Post-Anesthetic Transfer of Care Percentage of patients, regardless of age, who are under the care of an anesthesia practitioner and are admitted to a PACU in which a post-anesthetic formal transfer of care protocol or checklist which includes the key transfer of care elements is utilized TOC 02 One Pager TOC 02 Specification

TRAN 01: Transfusion Management Vigilance

Percentage of cases with a blood transfusion that have a hemoglobin or hematocrit value documented prior to transfusion. 

TRAN 01 One Pager

TRAN 01 Specification

TRAN 02: Post Transfusion Monitoring

Percentage of cases with a post transfusion hemoglobin or hematocrit value less than 10/30.

TRAN 02 One Pager

TRAN 02 Specification

Measures Under Development 

  1. PUL 02: Percentage of patients with median tidal volumes less than 8 ml/kg
  2. PONV 02: Percentage of patients, aged 3-17 years of age, who undergo a procedure under an general anesthesia in which an inhalational anesthetic is used for maintenance AND who have two or more risk factors for post-operative vomiting, who receive combination therapy consisting of at least two prophylactic pharmacologic antiemetic agents of different classes preoperatively or intraoperatively.
  3. CARD 03: Percentage of patients with high risk comorbidities with severely elevated postoperative troponin levels (Troponin I > 0.6)
  4. TOC 03 (MIPS 427): Post-anesthetic Transfer of Care: Use of checklist for transfer to ICU