Features  |   March 2017
Improving Patient Safety in Obstetric Anesthesia: An Introduction to the AQI AIRS Database
Author Affiliations
  • Robert D’Angelo, M.D.
    committee on obstetric anesthesia
Article Information
Obstetric Anesthesia / Patient Safety / Features
Features   |   March 2017
Improving Patient Safety in Obstetric Anesthesia: An Introduction to the AQI AIRS Database
ASA Monitor 03 2017, Vol.81, 20-21.
ASA Monitor 03 2017, Vol.81, 20-21.
Initiatives in recent decades to improve quality in medicine have and will continue to significantly impact anesthesia practice. In order to assess and improve quality, metrics must be identified, tracked and reported. This was particularly problematic in anesthesia in that, until recently,there were no clearly identified anesthesia metrics. Faced with this reality, the specialty either had to define metrics or they would be defined for us by forces outside of anesthesiology. In response to this challenge, the Anesthesia Quality Institute (AQI) was created in 2008. To achieve its vision of quality improvement of the clinical practice of anesthesiology by improving quality care of patients, lowering anesthesia mortality and lowering anesthesia incidents, AQI created a database in 2010, the National Anesthesia Clinical Outcomes Registry (NACOR). NACOR is currently capturing data from an ever-increasing number of anesthesiology practices and currently reports on 26 Physician Quality Reporting System (PQRS) and 19 ASA Quality Clinical Data Registry (ASA QCDR) metrics. Each of these 45 metrics can be categorized as “big data” by capturing and reporting data on population-level statistics. Examples include perioperative mortality (ASA QCDR #12), unplanned transfer or admission (ASA QCDR #37), pain brought under control within 48 hours (PQRS #342) and prevention of postoperative nausea and vomiting with combination therapy (PQRS #430). Although designed to improve outcomes on a global level, the registry fails to capture detailed data at the individual patient level.
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