Anesthesia Core Quality Metrics Consensus Delphi Study

Development of a Standardized Set of Core Metrics to Assess the Quality of Anesthesia, Perioperative Care, and Acute Pain Management in Canada: Scoping Review and Multidisciplinary Consensus Delphi Study

To develop a ranked list of up to 20 metrics, which can be used to evaluate the quality of anesthesia, perioperative care, and acute pain management for adult inpatient non-cardiac surgical patients for use in quality improvement and quality assurance, research, and continuing medical education in the Canadian care context.

Study Overview

• Status: Completed
• Conditions: Anesthesia; Consensus Development
• Intervention / Treatment: Other: Modified Delphi process

Detailed Description

Background: Improving anesthesiology care and perioperative outcomes is a growing field encompassing quality improvement and quality assurance, research, and continuing medical education. Multiple consensus initiatives have standardized perioperative endpoints. However, no standard set of metrics exist to evaluate the quality of Canadian anesthesiology care delivery.

Objective: Develop a ranked list of up to 20 metrics, which can be used to evaluate the quality of anesthesia, perioperative care, and acute pain management for adult inpatient non-cardiac surgical patients for use in quality improvement and quality assurance, research, and continuing medical education in the Canadian care context.

Methods: First, the steering committee will conduct a scoping review of the literature to identify candidate metrics, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) and Joanna Briggs Institute methodology for scoping reviews. Metrics will include patient-reported outcome and patient-reported experience measures, quality and safety indicators, process metrics, and Canadian Anesthesiologists' Society recommended practice standards. The search strategy will include English-language articles published or in use within the past seven years (2015/Jan-2022/March) in 1) MEDLINE, Embase, CINAHL, Web of Science, and Cochrane Database of Systematic Reviews, 2) grey literature, including guidelines, and 3) existing evaluation metrics used by Canadian departments for quality assurance and improvement. Screening and data extraction will be performed by two independent reviewers using Covidence.

Next, following approval from the Research Ethics Board and with written informed consent from participants, a multidisciplinary panel of anesthesiologists, people with lived surgical experience (patients, caregivers), surgeons, nurses, internal medicine and family physicians, hospital administrators, and researchers will iteratively review the list of candidate metrics using a modified Delphi process. Independent voting, using surveys over three rounds, will be used to identify the most important metrics to define the quality of anesthesia, perioperative care, and acute pain management. Additional cycles may be performed if required.

• Study Type: Observational
• Enrollment (Actual): 80

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V6Z 1Y6
      • St. Paul's Hospital
    • Vancouver, British Columbia, Canada, V6H 3N1
      • BC Children's Hospital
  • Newfoundland and Labrador
    • Saint John's, Newfoundland and Labrador, Canada, A1C 5S7
      • Memorial University of Newfoundland

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The investigators aim to recruit 77 participants with the following characteristics: a) 26 anesthesiologists, b) 26 patients and/or their family members/caregivers, c) 9 surgeons, d) 4 nurses, e) 2 physicians each from internal medicine, emergency department, family practice, family practice anesthetists, and 4 health administrators or quality improvement leads

Description

Inclusion Criteria:

• Patient/family participants must have undergone a surgical experience within the past three years, and have the capacity to provide informed consent.
• All other participants must be actively practising in Canada in the disciplines they represent.

Exclusion Criteria:

- Participants with self-declared conflicts of interest with this project.

Study Plan

How is the study designed?

Design Details

• Observational Models: Ecologic or Community
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Study participants	Other: Modified Delphi process; The study involves a brief demographics survey and Delphi process, i.e. three rounds of information and surveys, in which participants will be asked to score/rank potential metrics.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ranked list of anesthesia, perioperative care, and acute pain management quality metrics	A ranked set of national consensus metrics for evaluating the quality of anesthesia, perioperative care, and acute pain management for adult noncardiac surgical patients that can be used for quality improvement and quality assurance, research, and continuing medical education in the Canadian care context. Metrics where >70% participants voted "definitely priority" will be marked in the publication as the core metric set.	late 2022

Collaborators and Investigators

• Sponsor: University of British Columbia
• Investigators: Principal Investigator: Matthias Görges, PhD, The University of British Columbia

Publications and helpful links

Helpful Links

• Scoping review registration

Study record dates

Study Major Dates

• Study Start (Actual): September 26, 2022
• Primary Completion (Actual): November 1, 2023
• Study Completion (Actual): November 1, 2023

Study Registration Dates

• First Submitted: May 5, 2022
• First Submitted That Met QC Criteria: May 18, 2022
• First Posted (Actual): May 23, 2022

Study Record Updates

• Last Update Posted (Actual): February 28, 2024
• Last Update Submitted That Met QC Criteria: February 27, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Perioperative care; Outcomes; Metrics; Quality of anesthesia; Delphi
• Other Study ID Numbers: H22-00519

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No individual participant data will be shared.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No