M Chazapis1, D Gilhooly2, A F Smith3, P S Myles4, G Haller5, M P W Grocott6, S R Moonesinghe2. 1. Institute of Epidemiology and Applied Health Research, UK; UCLH Surgical Outcomes Research Centre, Department of Applied Health Research, UK; Department of Anaesthesia and Perioperative Medicine, University College Hospital, London, UK; National Institute for Academic Anaesthesia's Health Services Research Centre, Royal College of Anaesthetists, London, UK. Electronic address: m.chazapis@gmail.com. 2. Institute of Epidemiology and Applied Health Research, UK; UCLH Surgical Outcomes Research Centre, Department of Applied Health Research, UK; Department of Anaesthesia and Perioperative Medicine, University College Hospital, London, UK; National Institute for Academic Anaesthesia's Health Services Research Centre, Royal College of Anaesthetists, London, UK. 3. Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK. 4. Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia; Health Services Management and Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Australia. 5. Division of Anaesthesia, Department of Anaesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland. 6. Critical Care Research Group, Southampton NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust/University of Southampton, Southampton, UK.
Abstract
BACKGROUND: Clinical indicators assess healthcare structures, processes, and outcomes. While used widely, the exact number and level of scientific evidence of these indicators remains unclear. The aim of this study was to evaluate the number, type, and evidence base of clinical process and structure indicators currently available for quality and safety measurement in perioperative care. METHODS: We performed a systematic review searching Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Google Scholar, and System for Information in Grey Literature in Europe databases for English language human studies in adults (age >18) published in the past 10 years (January 2005-January 2016). We also included professional and governmental body publications and guidelines describing the development, validation, and use of structure and process indicators in perioperative care. RESULTS: We identified 43 860 journal articles and 43 relevant indicator program publications. From these, we identified a total of 1282 clinical indicators, split into structure (36%, n=463) and process indicators (64%, n=819). The dimensions of quality most frequently addressed were effectiveness (38%, n=475) and patient safety (29%, n=363). The majority of indicators (53%, n=675) did not have a level of evidence ascribed in their literature. Patient-centred metrics accounted for the fewest published clinical indicators. CONCLUSIONS: Despite widespread use, the majority of clinical indicators are not based on a strong level of scientific evidence. There may be scope in setting standards for the development and validation process of clinical indicators. Most indicators focus on the effectiveness, safety, and efficiency of care. PROSPERO DATABASE: CRD4201501277.
BACKGROUND: Clinical indicators assess healthcare structures, processes, and outcomes. While used widely, the exact number and level of scientific evidence of these indicators remains unclear. The aim of this study was to evaluate the number, type, and evidence base of clinical process and structure indicators currently available for quality and safety measurement in perioperative care. METHODS: We performed a systematic review searching Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Google Scholar, and System for Information in Grey Literature in Europe databases for English language human studies in adults (age >18) published in the past 10 years (January 2005-January 2016). We also included professional and governmental body publications and guidelines describing the development, validation, and use of structure and process indicators in perioperative care. RESULTS: We identified 43 860 journal articles and 43 relevant indicator program publications. From these, we identified a total of 1282 clinical indicators, split into structure (36%, n=463) and process indicators (64%, n=819). The dimensions of quality most frequently addressed were effectiveness (38%, n=475) and patient safety (29%, n=363). The majority of indicators (53%, n=675) did not have a level of evidence ascribed in their literature. Patient-centred metrics accounted for the fewest published clinical indicators. CONCLUSIONS: Despite widespread use, the majority of clinical indicators are not based on a strong level of scientific evidence. There may be scope in setting standards for the development and validation process of clinical indicators. Most indicators focus on the effectiveness, safety, and efficiency of care. PROSPERO DATABASE: CRD4201501277.
Authors: Hyla-Louise Kluyts; Wilhelmina Conradie; Estie Cloete; Sandra Spijkerman; Oliver Smith; Ahmed Alli; Modise Z Koto; Odisang D Montwedi; Komalan Govender; Larissa Cronjé; Mariette Grobbelaar; Jones A Omoshoro-Jones; Nicolette F Rorke; Philip Anderson; Alexandra Torborg; Christella Alphonsus; Panagiotis Alexandris; Aunel Mallier Peter; Usha Singh; Johan Diedericks; Busisiwe Mrara; Anthony Reed; Gareth L Davies; Jody G Davids; Hendrik A Van Zyl; Vishendran Govindasamy; Reitze Rodseth; Roel Matos-Puig; Kajake A P Bhat; Noel Naidoo; John Roos; Magdalena Jaworska; Annemarie Steyn; Johannes M Dippenaar; R M Pearse; Thandinkosi Madiba; Bruce M Biccard Journal: World J Surg Date: 2020-10-30 Impact factor: 3.352
Authors: Guy Haller; Sohail Bampoe; Tim Cook; Lee A Fleisher; Michael P W Grocott; Mark Neuman; David Story; Paul S Myles Journal: Br J Anaesth Date: 2019-05-23 Impact factor: 9.166
Authors: Sohail Bampoe; Tim Cook; Lee Fleisher; Michael P W Grocott; Mark Neuman; David Story; Paul Myles; Guy Haller Journal: BMJ Open Date: 2018-12-02 Impact factor: 2.692
Authors: Kaspar F Bachmann; Christian Vetter; Lars Wenzel; Christoph Konrad; Andreas P Vogt Journal: J Med Internet Res Date: 2019-08-15 Impact factor: 5.428
Authors: S Ramani Moonesinghe; Dermot McGuckin; Peter Martin; James Bedford; Duncan Wagstaff; David Gilhooly; Cristel Santos; Jonathan Wilson; Jenny Dorey; Irene Leeman; Helena Smith; Cecilia Vindrola-Padros; Kylie Edwards; Georgina Singleton; Michael Swart; Rachel Baumber; Arun Sahni; Samantha Warnakulasuriya; Ravi Vohra; Helen Ellicott; Anne-Marie Bougeard; Maria Chazapis; Aleksandra Ignacka; Martin Cripps; Alexandra Brent; Sharon Drake; James Goodwin; Dorian Martinez; Karen Williams; Pritam Singh; Matthew Bedford; Abigail E Vallance; Katie Samuel; Jose Lourtie; Dominic Olive; Christine Taylor; Olga Tucker; Giuseppe Aresu; Andrew Swift; Naomi Fulop; Mike Grocott Journal: Perioper Med (Lond) Date: 2022-08-09