PPAI: Mechanical Ventilation in the OR: Optimizing Patient Outcomes—A 3-stage performance improvement activity

Purchase Course & Materials

Course Fee
Member price: $220.00
Non-member price: $290.00

Course Description

THIS IS AN ONLINE ACTIVITY. Hard copies are not available.

Member price: $220.00, Non-member price: $290.00  

If you are interested in enrolling as a group for this topic, please send your request to educationcenter@asahq.org. Learn more.


 The American Board of Anesthesiology’s (ABA’s) Maintenance of Certification in Anesthesiology Program (MOCA®) Part 4 is titled Practice Performance Assessment and Improvement (PPAI).

Statement of Need. Mechanical ventilation (MV) management, even during relatively short operative periods, may contribute to nonspecific perioperative lung injury in many patients. In select high-risk patient groups, such as patients with acute respiratory distress syndrome (ARDS) or transfusion-related acute lung injury (TRALI), MV management may contribute to the development of clinically significant short- and long-term lung damage (ventilator-induced lung injury [VILI]). Specific MV strategies can prevent or reduce the VILI component of acute lung injury (ALI) and are associated with improved patient outcomes, including reductions in duration of postoperative ventilation, length of intensive care unit (ICU) stay, and mortality. Although the majority of the published literature focuses predominantly on the postoperative benefits of specific postoperative ventilator strategies, the use of these same strategies throughout the operative period also may be associated with significant patient benefits. Therefore, this learning module provides information that will enable the learner to

  • identify patients in the preoperative setting who are at risk for postoperative ALI
  • develop intraoperative MV strategies that reduce the risk of developing postoperative VILI. 

One PPAI activity is a case evaluation–based performance improvement activity. A case evaluation requires the collection of data from clinical outcomes or patient feedback, comparison to evidence-based practice guidelines, an educational activity, the design and implementation of a plan to improve outcomes, and assessment of the success of the interventions. All of these steps are facilitated by the electronic format of this ASA PPAI program.

NOTE: Care should be taken in selecting the appropriate PPAI topic. You will be required to provide actual data from patients’ charts in a secure environment. Please be sure to select a topic that is relevant to your practice.

There is a minimum 60-day wait period after creating your performance improvement plan (Stage 2), to implement the plan and collect 10 new cases. Please account for this 60-day wait period requirement to ensure your MOCA diplomate deadline is met.

This activity requires chart data from at least 20 patients who meet all of the following:

  • Experienced MV utilizing a tracheal or tracheostomy tube in the operating room (OR)
  • MV lasted 4 or more hours

*ABA diplomates enrolled in MOCA

  • MUST have their ABA ID number on file with ASA. See Update Profile Tutorial for directions on adding/verifying your ABA ID number on your Education Center profile.
  • MUST claim the maximum number of credits at each stage (for a total of 20 continuing medical education [CME] credits) to fulfill MOCA® requirement for PPAI.

These PPAI courses fulfill the case evalution requirement of Part 4 of the Maintenance of Certification in Anesthesiology Program (MOCA®)  of the American Board or Anesthesiology (ABA). Please consult the ABA website, www. theABA.org for a list of all MOCA® requirements.

Maintenance of Certification in Anesthesiology Program® and MOCA® are registered certification marks of The American Board of Anesthesiology®.

Learning Objectives:

After completing this module, the learner will be able to:
• screen patients for risk factors associated with postoperative ALI
• identify appropriate ventilator settings that reduce the risk of postoperative ALI
• maintain appropriate plateau pressure (Pplat) and other pressure targets during MV that reduce the risk of postoperative ALI.


Included activities:

Faculty & Credentials:

Editor-in-Chief: Leslie Jameson, M.D. receives consulting fees & honoraria from Masimo, honoraria from GE Medical.

Richard P. Dutton, M.D., M.B.A., Ex-Officio receives consulting fees from Sangart, Inc.
Kevin W. Hatton, M.D., Dawn Dillman, M.D., Mohammed Minhaj, M.D.,  Edward J. Park, M.D., Francine S. Yudkowitz, M.D. have no financial relationships with commercial interests

ASA Staff: Employees involved in planning have no relevant financial relationships to disclose.

Resolutions of Conflicts of Interest

In accordance with the ACCME Standards for Commercial Support of CME, the American Society of Anesthesiologists will implement mechanisms, prior to the planning and implementation of this CME activity, to identify and resolve conflicts of interest for all individuals in a position to control content of this CME activity.


The information provided at this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

Core Competencies:

Practice-based learning and improvement

Target Audience:

ABA diplomats enrolled in MOCA or any anesthesiologist interested in performance improvement.

CME Credit:

20.00 AMA PRA Category 1 Credit™

The American Society of Anesthesiologists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The American Society of Anesthesiologists designates this PI CME activity for a maximum of 20.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

20.00 Non-physician Credit

Non-physicians may receive a Certificate of Completion stating that this activity was designated for 20.00 AMA PRA Category 1 Credit(s)™.


Participants must complete the online modules, two chart audits, the required readings, and action plan and an evaluation.

Required Hardware / Software:

This program uses the following Web-based technologies: Flash, JavaScript, AJAX, and pop‐up windows. Subscribers need to be sure to set their browsers to allow these technologies to function on their computers before using this program. This program was tested using the following browsers: Internet Explorer 8–9 and Firefox 3.x on Windows platforms, and Firefox 3.x and Safari 3.x–5.x on Macintosh platforms. Performance on other browsers and/or platforms may vary. Adobe Reader is also required. NOTE: This program is NOT supported on iPad.

Activity Release Date:

01/31/2013 (All day)

Activity Expiration Date:

01/30/2016 (All day)

Estimated Time to Complete:

There is a minimum 60-day wait period after creating your performance improvement plan (Stage 2), to implement the plan and collect 10 new cases. Please account for this 60-day wait period requirement to ensure your MOCA diplomate deadline is met.