Prioritisation of quality indicators for elective perioperative care: a Delphi consensus.

Patient care Perioperative medicine Process indicators Quality measures Structure indicators

Journal

Perioperative medicine (London, England)
ISSN: 2047-0525
Titre abrégé: Perioper Med (Lond)
Pays: England
ID NLM: 101609072

Informations de publication

Date de publication:
2020
Historique:
received: 03 04 2019
accepted: 04 02 2020
entrez: 17 3 2020
pubmed: 17 3 2020
medline: 17 3 2020
Statut: epublish

Résumé

A systematic review of the peer-reviewed and grey literature previously identified over 1200 perioperative structure and process quality indicators. We undertook a Delphi consensus process with the aim of creating a concise list of indicators that experts deemed most important for assessing quality in perioperative care. A basic Delphi consensus was completed using an online survey which was distributed to surgeons, anaesthetists, nurses, physicians and lay representatives. Participants were asked to prioritise the indicators in order of importance (high, medium or low) to be included for collection in a national perioperative quality improvement programme. One hundred and thirty-seven indicators were included in the first iteration of the Delphi consensus (91 structure and 48 process indicators). Sixty-three experts agreed to participate and the consensus was completed in five rounds. Ninety-five indicators were agreed as high priority: 65 structural and 30 process indicators. The Delphi consensus process was able to reduce the number of recommended indicators to only a modest extent. Further work to evaluate the practicalities of routinely collecting such a comprehensive list of quality indicators is now required.

Sections du résumé

BACKGROUND BACKGROUND
A systematic review of the peer-reviewed and grey literature previously identified over 1200 perioperative structure and process quality indicators. We undertook a Delphi consensus process with the aim of creating a concise list of indicators that experts deemed most important for assessing quality in perioperative care.
METHODS METHODS
A basic Delphi consensus was completed using an online survey which was distributed to surgeons, anaesthetists, nurses, physicians and lay representatives. Participants were asked to prioritise the indicators in order of importance (high, medium or low) to be included for collection in a national perioperative quality improvement programme.
RESULTS RESULTS
One hundred and thirty-seven indicators were included in the first iteration of the Delphi consensus (91 structure and 48 process indicators). Sixty-three experts agreed to participate and the consensus was completed in five rounds. Ninety-five indicators were agreed as high priority: 65 structural and 30 process indicators.
CONCLUSION CONCLUSIONS
The Delphi consensus process was able to reduce the number of recommended indicators to only a modest extent. Further work to evaluate the practicalities of routinely collecting such a comprehensive list of quality indicators is now required.

Identifiants

DOI: 10.1186/s13741-020-0138-7 PMID: 32175078 PMC: PMC7063823
pubmed: 32175078
doi: 10.1186/s13741-020-0138-7
pii: 138
pmc: PMC7063823
doi:

Types de publication

Journal Article

Langues

eng

Pagination

8

Informations de copyright

© The Author(s). 2020.

Déclaration de conflit d'intérêts

Competing interestsNone.

Références

N Engl J Med. 2009 Jan 29;360(5):491-9
pubmed: 19144931
JAMA. 2010 Sep 8;304(10):1107-13
pubmed: 20823437
J Arthroplasty. 2013 Oct;28(9):1449-53
pubmed: 23890831
N Engl J Med. 2010 Nov 11;363(20):1928-37
pubmed: 21067384
Mater Sociomed. 2012;24(4):251-61
pubmed: 23922534
PLoS One. 2011;6(6):e20476
pubmed: 21694759
Med Care. 1999 Sep;37(9):964-8
pubmed: 10493474
Ann Thorac Surg. 2008 Sep;86(3):927-32
pubmed: 18721584
BMJ. 2010 Jan 18;340:c186
pubmed: 20083546
Anesthesiology. 2009 May;110(5):1158-75
pubmed: 19352148
Br J Anaesth. 2015 Oct;115(4):560-8
pubmed: 25926312
Br J Anaesth. 2018 Jan;120(1):51-66
pubmed: 29397138
Br J Anaesth. 2016 May;116(5):586-9
pubmed: 27106961
Can J Anaesth. 2016 Feb;63(2):159-68
pubmed: 26742948
Int J Qual Health Care. 2003 Dec;15(6):523-30
pubmed: 14660535
Nefrologia. 2014;34(2):158-74
pubmed: 24658191
J Arthroplasty. 2015 Dec;30(12):2071-5
pubmed: 26195355
JAMA. 1988 Sep 23-30;260(12):1743-8
pubmed: 3045356
J Am Coll Surg. 2004 Apr;198(4):626-32
pubmed: 15051016

Auteurs

D Gilhooly (D)

1UCL/UCLH NIHR Surgical Outcomes Research Centre, Centre for Perioperative Medicine, Division of Surgery and Interventional Science, Charles Bell House, University College London, London, W1W 7TS UK.
2Department of Anaesthesia and Perioperative Medicine, University College Hospital, London, NW1 2BU UK.
3Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, Churchill House, 35 Red Lion Square, London, WC1R 4SG UK.

M Chazapis (M)

1UCL/UCLH NIHR Surgical Outcomes Research Centre, Centre for Perioperative Medicine, Division of Surgery and Interventional Science, Charles Bell House, University College London, London, W1W 7TS UK.
2Department of Anaesthesia and Perioperative Medicine, University College Hospital, London, NW1 2BU UK.

S R Moonesinghe (SR)

1UCL/UCLH NIHR Surgical Outcomes Research Centre, Centre for Perioperative Medicine, Division of Surgery and Interventional Science, Charles Bell House, University College London, London, W1W 7TS UK.
2Department of Anaesthesia and Perioperative Medicine, University College Hospital, London, NW1 2BU UK.
3Health Services Research Centre, National Institute for Academic Anaesthesia, Royal College of Anaesthetists, Churchill House, 35 Red Lion Square, London, WC1R 4SG UK.

Classifications MeSH