Archive August 2017 XVIII, No. 8

Warming Up to Normothermia

A new CMS quality measure will require ASCs to track their ability to keep patients warm. Are you ready?

Bill Donahue

BIO

warming the patient START TO FINISH Warming the patient for every leg of the perioperative journey, from the pre-op bay to the recovery room, helps to maintain normothermia.

It's not like ambulatory surgical centers needed another incentive to warm patients, but now they have one anyway in the form of a quality measure they must begin reporting in 2018: "ASC-13: Normothermia Outcome."

Starting next year, ASCs must measure the percentage of patients having surgery under general or neuraxial anesthesia for 60 minutes or longer who are normothermic — a temperature of 35.5° C (95.9° F) or higher — within 15 minutes of arrival in the post-anesthesia care unit.

Validating hypothermia prevention, or at least measuring your efforts to do so, has been a part of hospital federal quality reporting requirements for many years, but is new to the ASC program.

"ASC-13: Normothermia Outcome" is among the new measures Medicare has added to the ASC Quality Reporting Program (ASCQRP) for 2018. Data collection begins in 2018, but the measure won't impact reimbursement until 2020. A few points worth noting:

  • The measure applies only to cases involving general or neuraxial anesthesia, which impair the body's ability to control thermoregulation. Patients who are under either monitored anesthesia care or treated with nerve blocks are exempt.
  • The measure doesn't include cases lasting less than an hour, even those that use general or neuraxial anesthesia.
  • You must submit data directly to CMS via a web-based tool.

"There's a lot of latitude in this measure," says anesthesiologist David Shapiro, MD, an ASC Quality Collaboration board member. "For example, you may not be reporting on a patient who is in for a 55-minute surgery, but you still need to make sure that patient is normothermic, for so many physiologic reasons. This measure is really about bringing more attention to the issue. Now is the time to make sure you have all the processes in place, and that you have strategized with your entire facility about how to collect the data needed to meet the specs of the measure."

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