Normothermia Data Collection Begins in 2018 Attend ASCA 2017 to learn about the new measure and how to report correctly BY DAVID SHAPIRO, MD, CASC

ASCs will need to start collecting data to report the ASC-13: Normother- mia Outcome measure as part of their quality mea-

sure reporting in 2018. The Centers for Medicare & Medicaid Services (CMS) adopted the measure as a part of its final 2017 ASC Payment Rule released in November 2016. In my presenta- tion, “The Importance of Maintaining Normothermia and Quality Measure Reporting” at ASCA 2017, May 3–5, in Washington, DC, I will share tips on how ASCs can stay on top of this new quality measure.

The intent of the normothermia

measure is to capture the percentage of patients that had general or neuraxial anesthesia of 60 minutes or more in duration and are normothermic (body temperature equal to or greater than 96.8 Fahrenheit/36 Celsius) within 15 minutes of arrival in the post-anesthe- sia care unit (PACU).

The concept of maintaining patient normothermia is not new, and most clinicians are aware of its importance. In fact, much research documenting the clinical significance of perioperative patient temperatures has been published throughout the past several decades. The reporting of this parameter has been a part of hospital federal quality reporting requirements for many years but is new to the ASC program. The components of the measure itself are somewhat subject to interpretation, and will be closely examined during the presentation. Together, we will look at the definitions, the numerators and denominators, and other elements of the measure specifications. Further, we will discuss various ways to collect and


preoperative evaluation and prepara- tion so as to incorporate the issue of patient thermal regulation through- out the continuum of perioperative care. In addition to the many other elements of preoperative prepara- tion, ASCs will need to examine such variables as the patient’s underlying comorbidities, anesthesia require- ments and the scheduled length of the procedure to gauge the relative risk of hypothermia to implement the required measures.

During the session, I will address

document the relevant data, as well as facilitate the actual reporting to CMS through the QualityNet portal. I also will discuss the importance of the measure in terms of the clini- cal implications of maintaining nor- mothermia throughout all phases of patient care in a surgical setting. This includes the physiologic risks of hypothermia, as well as the bene- fits of providing an environment that ensures adequate thermoregulation. I will go over the most common causes of hypothermia during the periop- erative phases and, then, talk about some of the different means of con- trolling and modifying patient tem- perature to maintain normothermia in the ASC setting.

In light of the forthcoming increased scrutiny focused on ther- moregulation, ASCs might want to reevaluate their general approach to

some of the most critical components of creating an appropriate approach to these considerations and explore how best to measure temperatures perioperatively. Additionally, I will review some of the many techniques and products available to facilitate and maintain normothermia. Some of these strategies are fairly basic, such as raising the temperature of the operating room and applying warmed blankets; others are a bit more involved, such as using one or more of the numerous patient warm- ing devices currently on the market. Hopefully,

at the conclusion of

the session, you will feel more com- fortable not only with establishing internal protocols for data collection and reporting this measure but, more importantly, with using this informa- tion to enhance the care you deliver at your facility. I look forward to seeing you in DC

at ASCA 2017.

David Shapiro, MD, CASC, is an ex-ASCA Board president and anesthesiologist at Red Hills Surgical Center in Tallahassee, Florida. Write him at

Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30