At the recent meeting of the American Association of Clinical Directors (AACD), I learned that the American Association of Anesthesiologists (ASA) had set up the Anesthesia Quality Institute (AQI) (www.aqihq.org). The Institute’s vision is to become “the primary source for quality improvement in the clinical practice of anesthesiology,” while its mission is to establish and maintain the National Anesthesia Clinical Outcomes Registry. (I could put in all the acronyms but it would make your eyes glaze over).
If this sounds to you like a cousin of the National Surgical Quality Program (NSQIP), you’d be almost right: Having observed NSQIP, Rick Dutton, MD, AQI’s Executive Director, has taken a different approach to membership and to the collection and analysis of data.
Because storage capacity is infinite and because bandwidth will continue to increase, he decided that the system should collect all reasonably useful data on all cases of participating institutions; moreover, that membership should be almost free. (It’s subsidized by the ASA).
After you sign up, “pipes” are set up to channel your data – de-identified – into a massive data base. The choices made by Rick allow for flexible, but potentially complex, analyses. By contrast – and probably for good reasons – NSQIP collects carefully defined data on selected cases (only), and requires that data be checked by a full-time assessor, who is trained and periodically re-qualified by NSQIP.
It’s gratifying that the ASA has set up the Anesthesia Quality Institute.
When it comes to surgery, anesthesiologists feel particularly responsible for post operative nausea/vomiting, and for pain. In recognition of this, the data collected and adjusted by the Institute will permit benchmarking on those two quality dimensions.
Now, all that we need is a joint program – one that combines NSQIP and a subset of the data from the Anesthesia Quality Institute.
After all, anesthesiologists’ complications are indistinguishable from those of surgeons from the perspective that matters most: the patient’s.