Southlake Regional Health Centre, Newmarket, ON, L3Y 2P9, Canada.
Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
BMC Anesthesiol. 2023 Jul 31;23(1):256. doi: 10.1186/s12871-023-02195-w.
Implementation of the new competency-based post-graduate medical education curriculum has renewed the push by medical regulatory bodies in Canada to strongly advocate and/or mandate continuous quality improvement (cQI) for all physicians. Electronic anesthesia information management systems contain vast amounts of information yet it is unclear how this information could be used to promote cQI for practicing anesthesiologists. The aim of this study was to create a refined list of meaningful anesthesia quality indicators to assist anesthesiologists in the process of continuous self-assessment and feedback of their practice.
An initial list of quality indicators was created though a literature search. A modified-Delphi (mDelphi) method was used to rank these indicators and achieve consensus on those indicators considered to be most relevant. Fourteen anesthesiologists representing different regions across Canada participated in the panel.
The initial list contained 132 items and through 3 rounds of mDelphi the panelists selected 56 items from the list that they believed to be top priority. In the fourth round, a subset of 20 of these indicators were ranked as highest priority. The list included items related to process, structure and outcome.
This ranked list of anesthesia quality indicators from this modified Delphi study could aid clinicians in their individual practice assessments for continuous quality improvement mandated by Canadian medical regulatory bodies. Feasibility and usability of these quality indicators, and the significance of process versus outcome measures in assessment, are areas of future research.
新的基于能力的研究生医学教育课程的实施，促使加拿大医学监管机构大力倡导和/或要求所有医生进行持续质量改进（CQI）。电子麻醉信息管理系统包含大量信息，但尚不清楚如何利用这些信息来促进执业麻醉师的 CQI。本研究旨在创建一个经过改进的有意义的麻醉质量指标清单，以帮助麻醉师进行持续的自我评估和实践反馈。
通过文献检索创建了初始质量指标清单。采用改良德尔菲法（mDelphi）对这些指标进行排名，并就被认为最相关的指标达成共识。来自加拿大各地不同地区的 14 名麻醉师参加了该小组。
初始清单包含 132 项，通过 3 轮 mDelphi，小组成员从清单中选出了他们认为最优先的 56 项。在第 4 轮中，这 20 个指标中的一个子集被列为最高优先级。该清单包括与过程、结构和结果相关的指标。
本研究通过改良 Delphi 研究得出的这份经排名的麻醉质量指标清单，可以帮助临床医生进行个人实践评估，以满足加拿大医学监管机构规定的持续质量改进要求。这些质量指标的可行性和可用性，以及评估中过程与结果衡量的重要性，是未来研究的领域。
