Ke Janny X C, Sparrow Kathryn, Smith Mindy A, Yoo Kang Mu, Yee May-Sann, Sun Louise Y, Beattie W Scott, Lim Edlyn, Görges Matthias
Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada.
Department of Anesthesia, St. Paul's Hospital, Providence Health Care, Vancouver, BC, Canada.
Can J Anaesth. 2025 May 20. doi: 10.1007/s12630-025-02943-1.
PURPOSE: The aim of this scoping review was to consolidate a list of metrics that can be used to measure quality in anesthesiology, perioperative medicine, and acute pain management in Canada. METHODS: We included English-language full-text articles involving metrics (including patient-reported outcome and patient-reported experience measures, quality and safety indicators, and practice standards) for adults aged 18 yr and older undergoing inpatient non-cardiac surgery requiring an anesthesiologist. We searched MEDLINE®, Embase, CINAHL, Web of Science™, the Cochrane Database of Systematic Reviews, and grey literature to find articles on the topic from January 2015 to March 2022. In addition, we contacted 64 Canadian hospitals for existing anesthesia quality assurance and improvement metrics; they responded from June to October 2022. Two independent reviewers performed screening and data extraction. We grouped and condensed similar candidate metrics using thematic analysis. RESULTS: We assessed 4,493 publications, of which 63 met the inclusion criteria. We extracted 662 candidate metrics and consolidated them into 94 distinct metrics. Metrics reflected themes of perioperative management (n = 47), safety and standards (n = 23), patient-centredness (n = 11), intraoperative anesthetic care (n = 5), perioperative team leadership (n = 4), and efficiency (n = 4). Metrics spanned all quality-of-care categories (process, outcome, and structure) and perioperative phases but were limited by poor supporting evidence. CONCLUSIONS: We consolidated a list of 94 metrics that can be used to evaluate the quality of anesthesia care. Further work will require verification of feasibility and validity prior to adoption, with operationalization of these metrics into practical indicators that are measurable and comparable.
目的:本范围综述的目的是整理一份可用于衡量加拿大麻醉学、围手术期医学和急性疼痛管理质量的指标清单。 方法:我们纳入了涉及18岁及以上接受需要麻醉医生的非心脏住院手术的成年人的指标(包括患者报告的结局和患者报告的体验指标、质量和安全指标以及实践标准)的英文全文文章。我们检索了MEDLINE®、Embase、CINAHL、Web of Science™、Cochrane系统评价数据库和灰色文献,以查找2015年1月至2022年3月期间关于该主题的文章。此外,我们联系了64家加拿大医院,了解现有的麻醉质量保证和改进指标;它们于2022年6月至10月做出了回应。两名独立评审员进行筛选和数据提取。我们使用主题分析对相似的候选指标进行分组和汇总。 结果:我们评估了4493篇出版物,其中63篇符合纳入标准。我们提取了662个候选指标,并将它们汇总为94个不同的指标。指标反映了围手术期管理(n = 47)、安全和标准(n = 23)、以患者为中心(n = 11)、术中麻醉护理(n = 5)、围手术期团队领导(n = 4)和效率(n = 4)等主题。指标涵盖了所有护理质量类别(过程、结局和结构)和围手术期阶段,但受支持证据不足的限制。 结论:我们整理了一份94个指标的清单,可用于评估麻醉护理质量。在采用之前,进一步的工作需要验证其可行性和有效性,并将这些指标转化为可测量和可比的实际指标。
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