Health Services Research Centre, Royal College of Anaesthetists, London, UK.
Centre for Perioperative Medicine, Research Department of Targeted Intervention, University College London, London, UK.
BMJ Open. 2019 Jul 10;9(7):e030214. doi: 10.1136/bmjopen-2019-030214.
The Perioperative Quality Improvement Programme (PQIP) is designed to measure complications after major elective surgery and improve these through feedback of data to clinicians. Previous research suggests that despite the significant resources which go into collecting data for national clinical audits, the information they contain is not always used effectively to improve local services.
We will conduct a formative process evaluation of PQIP comprising a multisited qualitative study to analyse PQIP's programme theory, barriers, facilitators and wider contextual factors that influence implementation. The research will be carried out with the PQIP project team and six National Health Service (NHS) Trusts in England, selected according to geographical location, type of hospital, size and level of engagement with PQIP. We will include one Trust which has not expressed interest in the PQIP for comparison and to explore the role of secular trend in any changes in practice. We will use semi-structured interviews (up to 144 in Trusts and 12 with the project team), non-participant observations (up to 150 hours) and documentary analysis. We will track the lifecycle of perioperative data, exploring the transformations it undergoes from creation to use. We will use framework analysis with categories both from our research questions and from themes emerging from the data.
Ethical approval has been granted from the University College London Research Ethics Committee (ref 10375/001). Permissions to conduct research at NHS Trusts have been granted by local Research and Development offices in coordination with the Health Research Authority. We will follow guidelines for data security, confidentiality and information governance. Findings will be shared at regular time points with the PQIP project team to inform the implementation of the programme, and with participating NHS Trusts to help them reflect on how they currently use data for improvement of perioperative services.
围手术期质量改进计划（PQIP）旨在测量主要择期手术后的并发症，并通过将数据反馈给临床医生来改善这些并发症。先前的研究表明，尽管为国家临床审计收集数据需要投入大量资源，但它们所包含的信息并不总是被有效地用于改善当地服务。
我们将对 PQIP 进行形成性过程评估，包括一项多地点定性研究，以分析 PQIP 的计划理论、障碍、促进因素和影响实施的更广泛的背景因素。该研究将与 PQIP 项目团队和英格兰的六家国民保健服务（NHS）信托机构合作进行，这些信托机构是根据地理位置、医院类型、规模和参与 PQIP 的程度选择的。我们将包括一家对 PQIP 不感兴趣的信托机构进行比较，以探讨在任何实践变化中世俗趋势的作用。我们将使用半结构化访谈（在信托机构中最多 144 次，在项目团队中最多 12 次）、非参与观察（最多 150 小时）和文献分析。我们将跟踪围手术期数据的生命周期，探索它从创建到使用所经历的转变。我们将使用框架分析，其类别既来自我们的研究问题，也来自数据中出现的主题。
伦敦大学学院伦理委员会已批准该研究（参考号 10375/001）。当地研究与发展办公室在与卫生研究管理局协调的情况下，已批准在 NHS 信托机构进行研究的许可。我们将遵循数据安全、保密和信息管理的准则。研究结果将定期与 PQIP 项目团队分享，以告知该计划的实施情况，并与参与的 NHS 信托机构分享，以帮助他们反思当前如何利用数据改善围手术期服务。
