The Gap between Compliance with the Quality Performance Measure “Perioperative Temperature Management” and Normothermia

Abstract

The National Quality Forum (NQF) has endorsed the process performance measure Perioperative Temperature Management, which is used by the Joint Commission and the Centers for Medicare and Medicaid Services. Compliance requires either using active warming intraoperatively or achieving normothermia near the end of anesthesia. Compliance may actually be achieved by using forced-air warming incorrectly and without maintaining normothermia. The aim of this study was to determine to what extent compliance with the NQF-endorsed quality performance measure, is congruent with normothermia at the end of the surgical procedure. This study describes the relationship between compliance with this measure and the outcome of normothermia upon admission to the postanesthesia care unit. A retrospective review was undertaken of patients undergoing surgery with general or neuraxial anesthesia during a 48-month period of time in a community hospital. A total of 5.8% of patients for whom the quality performance measure was met were hypothermic upon admission to the postanesthesia care unit. The greatest gaps between compliance with the measure and normothermia were found in urology (8.5%) and orthopedics (7.7%). Patients who receive care compliant with the quality performance measure by receiving active warming are still at risk for hypothermia.