Gilhooly D, Chazapis M, Moonesinghe S R
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.
Perioper Med (Lond). 2020 Mar 10;9:8. doi: 10.1186/s13741-020-0138-7. eCollection 2020.
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.
对同行评审文献和灰色文献进行的系统评价先前已确定了1200多个围手术期结构和过程质量指标。我们开展了德尔菲共识程序，目的是创建一份专家认为对评估围手术期护理质量最为重要的指标简表。
通过在线调查完成了基本的德尔菲共识程序，该调查分发给外科医生、麻醉师、护士、内科医生和非专业代表。要求参与者按照重要性顺序（高、中或低）对指标进行排序，以便纳入国家围手术期质量改进计划进行收集。
德尔菲共识的第一轮纳入了137项指标（91项结构指标和48项过程指标）。63名专家同意参与，共识在五轮中完成。95项指标被确定为高度优先：65项结构指标和30项过程指标。
德尔菲共识程序仅在一定程度上减少了推荐指标的数量。现在需要进一步开展工作，以评估常规收集如此全面的质量指标清单的可行性。
