W
arm blankets and warming
devices are easy-to-apply inter-
ventions that prevent a
patient's temperature from dip-
ping below 36°C before, during
and after surgery. So why is inadvertent periopera-
tive hypothermia still an issue? Spectrum
Healthcare Partners, a multispecialty physician-
owned medical group based in Southport, Maine,
had been documenting how many patients are nor-
mothermic when they come out of the OR at the
group's former orthopedic surgery centers.
"We'd been measuring that rate for a long time
within our anesthesia group," says Miriam Dowling-
Schmitt, MS, RN, CPHQ, CPPS, director of quality at
Spectrum. "Although a majority of our patients
were emerging from surgery normothermic, we
noticed some opportunities for improvement."
The ultimate push for change came at the start
of 2018, when CMS began requiring the documenta-
tion of a normothermic temperature reading within
15 minutes of a patient's arrival in the PACU as a
quality metric of the Ambulatory Surgery Center
Quality Reporting (ASCQR) Program. Spectrum
seized the opportunity to review their internal data
to make sure the patient warming practices at the
surgery centers met the ASCQR's national bench-
mark of 95% or more of patients being normother-
mic in recovery.
Ms. Dowling-Schmitt launched a quality improve-
ment project based on methodology used in Lean
Six Sigma: Define, Measure, Analyze, Improve,
Control (DMAIC).
• Define and measure. They began by identify-
ing the problem and assessing why it was happen-
ing. Ms. Dowling-Schmitt's team reviewed the
records of patients who did not meet the nor-
mothermic metric and discovered 87.1% of
4 8 • O U T P A T I
E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 2 0
Normothermia Is the New Normal
Turn up the heat on proactive patient
warming to stave off the chilling effects of surgery.
Dan Cook | Editor-in-Chief
WARMING TREND Efforts to improve warming practices must begin
with an assessment of patient temperature readings over time.
