Join our conversation
In person
If you are unable to join with the below options, there will be a physical space reserved in the Foundation for Health Care Quality’s Seattle office to participate in the virtual meeting at the below address:
Industrious 400U @ Rainier Square
400 University Street
Floor 3
Seattle, WA 98101
Online
Background
Modifiable attributes of patient health status such as anemia or blood sugar control can have negative consequences for recovery after surgery. Preoperatively anemic individuals have higher costs generally due to increased length of stay[i] and even mild preoperative anemia is associated with an increase in 30-day morbidity[ii] lower quality of recovery and higher adjusted risk of death and disability.[iii] Some studies suggest poor A1c control preoperatively increases morbidity and mortality,[iv] but perioperative glucose is a stronger predictor of 30-day mortality.[v] Enhanced Recovery After Surgery (ERAS) protocols improve length of stay and reduce total cost of care, complications, and readmissions.[vi] However, Washington State has variation for A1c optimization before surgery, perioperative glycemic control protocols, and perioperative anemia control. Black patients are three to four times more likely to experience anemia perioperatively; Black, Hispanic, American Indian/Alaska Native patients more likely to experience uncontrolled diabetes/serum glucose, leading to inequitable outcomes.
| Next Meeting | Time | Materials |
| Mar 4th, 2025 | 7-8:30am | Please see below |
Meeting Materials
| Date | Materials |
| January 17th, 2025 | |
| February 4th | February Agenda January Minutes Evidence Table/Narrative Review/Draft Workplan/Anemia_Refs_Patch |
| March 4th | March Agenda February Minutes Materials/Workplan |
| April 1st | April Agenda March Minutes Materials/Evidence Table |
| May 6th | May Agenda April Minutes Materials/Evidence Table |
| June 3rd | June Agenda May Minutes Evidence Table Materials |
| July 1st | July Agenda June Minutes Materials/Evidence Table |
| August 5th | August Agenda July Minutes Materials/Evidence Table |
| September 2nd | September Agenda August Minutes Materials |
| October 7th | October Agenda September Minutes Materials |
| November 4th | November Agenda October Minutes Draft Report & Guidelines |
Workgroup Members
| Name | Title | Organization |
| Carl Olden, MD (chair) | UW Residency Program Manager, Family Medicine Physician |
Central Washington Family Medicine |
| Nicholas J. Kassebaum, MD | Medical Director | SCOAP/Spine COAP |
| Vickie Kolios-Morris, MSHSA, CHPQ | Senior Program Director | SCOAP/Sping COAP |
| Cristina Stafie, MD | Medical Director Perioperative and Procedural Services | Kaiser Permanente |
| Dayna Weatherly-Wilson, RN | Manager, Value Based Care | Proliance |
| Eduardo Smith Singares, MD FACS, FCCM | Medical Director for Trauma & Emergency Surgical Services | Kadlec Medical Center |
| Rosemary Grant, BSN, RN, CHPQ, CPPS | Director, Clinical Excellence | Washington State Hospital Association |
| Timothy Barnwell, MD | Anesthesiologist | Confluence |
| Nawar Alkhamesi, PhD, MBA | Colorectal Surgeon | Kadlec Medical Center |
| Thien Nguyen, MD | OMC Surgery Section Chair, Director of OC Surgical Subspecialties | Overlake Medical Center |
| Andrea Allen, RN, MHA | Nurse Consultant, Program Manager, WA Apple Health, Fee For Service | Washington HCA |
| Irl Hirsch, MD | Medical Director | UW Diabetes Institute |
| E. Patchen Dellinger, MD | Professor Emeritus | University of Washington, Department of Surgery |
| Ty Jones, MD, CPPS, CHPW, CAQSM | Medical Director, Patient Safety and Healthcare Quality Leader | Regence |
| Robert Rush, MD | Chief Medical Officer Surgical Services | PeaceHealth Saint Joseph |
| Joe Frankhouse, MD, FACS | Colorectal Surgeon | Legacy Health |
| Scott Helton, MD, FACS | Director of Liver, Biliary, Pancreas Surgery Center of Excellence | Virginia Mason Medical Center |
| Venu Nemani, MD | Orthopedic Spine Surgeon | Virginia Mason Franciscan Health |
| Michael Bota, MD | Medical Director Population Health Clinical Value | MultiCare Connected Care |
| Janice Tufte | Patient Partner | Muslim Resource Center |
| Sharon Eloranta, MD | Medical Director | Washington Health Alliance (WHA) |
| Edie Shen, MD | Perioperative Internist | Harborview Medical Center |
[i] Schatz C, Plötz W, Beckmann J, Bredow K, Leidl R, Buschner P. Associations of preoperative anemia and postoperative hemoglobin values with hospital costs in total knee arthroplasty (TKA). Arch Orthop Trauma Surg. 2023 Nov;143(11):6741-6751.
[ii] Musallam KM, et al. . Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet. 2011 Oct 15;378(9800):1396-407.
[iii] Myles, P. S., Richards, T., Klein, A., Wood, E. M., Wallace, S., Shulman, M. A., Martin, C., Bellomo, R., Corcoran, T. B., Peyton, P. J., Story, D. A., Leslie, K., Forbes, A., & RELIEF Trial Investigators (2022). Postoperative anaemia and patient-centred outcomes after major abdominal surgery: a retrospective cohort study. British journal of anaesthesia, 129(3), 346–354. https://doi.org/10.1016/j.bja.2022.06.014
[iv] Hart, A., Goffredo, P., Carroll, R., Lehmann, R., Nau, P., Smith, J., Ahad, S., Bao, W., & Hassan, I. (2021). Optimizing Bariatric Surgery outcomes: the impact of preoperative elevated hemoglobin A1c levels on composite perioperative outcome measures. Surgical endoscopy, 35(8), 4618–4623.
[v] van den Boom, W., Schroeder, R. A., Manning, M. W., Setji, T. L., Fiestan, G. O., & Dunson, D. B. (2018). Effect of A1C and Glucose on Postoperative Mortality in Noncardiac and Cardiac Surgeries. Diabetes care, 41(4), 782–788.
[vi] Mazni Y, Syaiful RA, Ibrahim F, Jeo WS, Putranto AS, Sihardo L, Marbun V, Lalisang AN, Putranto R, Natadisastra RM, Sumariyono S, Nugroho AM, Manikam NRM, Karimah N, Hastuty V, Sutisna EN, Widiati E, Mutiara R, Wardhani RK, Liastuti LD, Lalisang TJM. The enhanced recovery after surgery (ERAS) protocol implementation in a national tertiary-level hospital: a prospective cohort study. Ann Med Surg (Lond). 2023 Dec 8;86(1):85-91.