John Di Capua, MD, is deputy CEO and chief medical officer of North American Partners in Anesthesia Corp.; vice president of anesthesia services of North Shore-Long Island Jewish Health System; and chairman and the Peter Walker Professor of Anesthesiology in the department of anesthesiology of Hofstra University-North Shore LIJ School of Medicine.
Q: NAPA tracks 31 different indicators as part of its quality assurance program. How does NAPA determine what quality indicators it should be tracking and measuring?
Dr. John Di Capua: When you think about quality indicators and the data you should be collecting, we look at two different categories of events: critical and non-critical events. Clearly, you should be collecting data on significant critical events that should rarely happen, such as when a patient comes to harm. In addition, it's important to collect data on non-critical events that happen post-operatively in order to minimize those occurrences as well. These would include frequent events like nausea, hypertension, high blood pressure or pain in the recovery area.
As part of our quality assurance program, it is NAPA's practice to track all 31 indicators by institution, by service and by practitioner. We then review the data points and compare them to our benchmark scale to determine why somebody is either not meeting, or often exceeding in a specific area. We are then able to use that information to move things toward the right standard, and determine the best practice.
There are national and statewide standards — the Anesthesia Business Group, IHI and ASA, for example. We certainly support, and participate in that level of national quality mission. As part of our quality assurance program, we also include a benchmark against national norms derived from some of these sources.
Hospitals are always very interested in that type of quality information. If you're able to bring data on issues it has tremendous value to a hospital, especially now that it has moved to a pay-for-performance metric.
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