Development and measurement of perioperative patient safety indicators

Emond, Yvette; Stienen, J.J.C.; Wollersheim, H.C.H.; Bloo, Gerrit; Damen, Johan; Westert, Gert P; Boermeester, Marja A.; Pols, Margreet A.; Calsbeek, Hiske; Wolff, André

doi:10.1093/bja/aeu561

Cited by 14 publications

(33 citation statements)

References 25 publications

(11 reference statements)

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“…The chosen cut-off point of 90 per cent indicating good or poor compliance, as used in previous studies [24][25][26][27] , may need revision in the future. It could be argued that 100 per cent compliance should be the goal for all patient safety topics.…”

Section: Discussionmentioning

confidence: 99%

“…The aim of the present multicentre observational pilot study was to develop a comprehensive and easy-to-use Surgical Patient safety Observation Tool (SPOT) to measure perioperative safety performance in daily clinical practice and to identify safety improvement areas. The development procedure included pilot testing of SPOT in eight hospitals to assess the clinimetric characteristics in line with previous studies [24][25][26][27] . Feasibility was added to these characteristics ( Table 3).…”

Section: Introductionmentioning

confidence: 99%

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Development of the Surgical Patient safety Observation Tool (SPOT)

et al. 2018

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BackgroundA Surgical Patient safety Observation Tool (SPOT) was developed and tested in a multicentre observational pilot study. The tool enables monitoring and benchmarking perioperative safety performance across departments and hospitals, covering international patient safety goals.MethodsNineteen perioperative patient safety observation topics were selected from Dutch perioperative patient safety guidelines, which also cover international patient safety goals. All items that measured these selected topics were then extracted from available local observation checklists of the participating hospitals. Experts individually prioritized the best measurement items per topic in an initial written Delphi round. The second (face to face) Delphi round resulted in consensus on the content of SPOT, after which the measurable elements (MEs) per topic were defined. Finally, the tool was piloted in eight hospitals for measurability, applicability, improvement potential, discriminatory capacity and feasibility.ResultsThe pilot test showed good measurability for all 19 patient safety topics (range of 8–291 MEs among topics), with good applicability (median 97 (range 11·8–100) per cent). The overall improvement potential appeared to be good (median 89 (range 72·5–100) per cent), and at topic level the tool showed good discriminatory capacity (variation 27·5 per cent, range in compliance 72·5–100 per cent). Overall scores showed relatively little variation between the participating hospitals (variation 13 per cent, range in compliance 83–96 per cent). All eight auditors considered SPOT a straightforward and easy‐to‐use tracer tool.ConclusionA comprehensive tool to measure safety of care was developed and validated using a systematic, stepwise method, enabling hospitals to monitor, benchmark and improve perioperative safety performance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of the Surgical Patient safety Observation Tool (SPOT)

et al. 2018

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“…The study consisted of two parts ( Fig . ): evaluating and improving the preliminary questionnaire by means of a RAND‐modified Delphi consensus procedure ; and validating SIPPS by pilot‐testing the instrument on its clinimetric characteristics in five hospitals ( Table ). The self‐assessment questionnaire is a translation of the content of the perioperative guidelines into questions answered by a preselected group of healthcare providers working in the perioperative trajectory.…”

Section: Methodsmentioning

confidence: 99%

“…SOP, standard operating procedure. (31), anaesthetists (21), pharmacists (13), nurses working in the preanaesthesia care unit (17), nurses working in the admissions department (18), operating room (OR) managers (25), quality and safety managers (14), medical technologists (19), anaesthesiology employees working in the outpatient clinic (25), OR planners (27), surgical physicians (16), OR nurses (28), employees working in the polyclinic department with the exception of anaesthesia (15), postanaesthesia care nurses (25), surgical ward nurses (19), medical technology employees (14) and logistics employees (18). In total, 12 139 evaluating answers and 495 comments were received.…”

Section: Evaluating and Improving The Preliminary Questionnairementioning

confidence: 99%

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Development and validation of a Self-assessment Instrument for Perioperative Patient Safety (SIPPS)

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BackgroundPatient safety is a fundamental value of healthcare to avoid patient harm. Non‐compliance with patient safety standards may result in patient harm and is therefore a global concern. A Self‐assessment Instrument for Perioperative Patient Safety (SIPPS) monitoring and benchmarking compliance to safety standards was validated in a multicentre pilot study.MethodsA preliminary questionnaire, based on the Dutch perioperative patient safety guidelines and covering international patient safety goals, was evaluated in a first digital RAND Delphi round. The results were used to optimize the questionnaire and design the SIPPS. For measurement and benchmarking purposes, SIPPS was categorized into seven main patient safety domains concerning all care episode phases of the perioperative trajectory. After consensus was reached in a face‐to‐face Delphi round, SIPPS was pilot‐tested in five hospitals for five characteristics: measurability, applicability, improvement potential, discriminatory capacity and feasibility.ResultsThe results of the first Delphi round showed moderate feasibility for the preliminary questionnaire (81·6 per cent). The pilot test showed good measurability for SIPPS: 99·8 per cent of requested information was assessable. Some 99·9 per cent of SIPPS questions were applicable to the selected respondents. With SIPPS, room for improvement in perioperative patient safety compliance was demonstrated for all hospitals, concerning all safety domains and all care episode phases of the perioperative trajectory (compliance 76·1 per cent). SIPPS showed mixed results for discriminatory capacity. SIPPS showed good feasibility for all items (range 91·9–95·7 per cent).ConclusionA self‐assessment instrument for measuring perioperative patient safety (SIPPS) compliance meeting international standards was validated. With SIPPS, improvement areas for perioperative patient safety and best practices across hospitals could be identified.

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Implementation of anesthesia quality indicators in Germany

et al. 2020

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Background In 2016 the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Association of German Anesthetists (BDA) published 10 quality indicators (QI) to compare and improve the quality of anesthesia care in Germany. So far, there is no evidence for the feasibility of implementation of these QI in hospitals. Objective This study tested the hypothesis that the implementation of the 10 QI is feasible in German hospitals. Material and methods This prospective three-phase national multicenter quality improvement study was conducted in 15 German hospitals and 1 outpatient anesthesia center from March 2017 to February 2018. The trial consisted of an initial evaluation of pre-existing structures and processes by the heads of the participating anesthesia departments, followed by a 6-month implementation phase of the QI as well as a final re-evaluation phase. The implementation procedure was supported by web-based implementation aids (www.qi-an.org) and internal quality management programs. The primary endpoint was the difference in the number of implemented QI per center before and after implementation. Secondary endpoints were the number of newly implemented QI per center, the overall number of successful implementations of each QI, the identification of problems during the implementation as well as the kind of impediments preventing the QI implementation. Results The average number of implemented QI increased from 5.8 to 6.8 (mean of the differences 1.1 ± 1.3; P < 0.01). Most frequently the QI perioperative morbidity and mortality report (5 centers) and the QI temperature management (4 centers) could be implemented. After the implementation phase, the QI incidence management and patient blood management were implemented in all 16 centers. Implementation of other quality indicators failed mainly due to a lack of time and lack of structural resources. Conclusion In this study the implementation of QI was proven to be mostly feasible in the participating German hospitals. Although several QI could be implemented with minor effort, more time, financial and structural resources would be required for some QI, such as the QI postoperative visit.

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Development and measurement of perioperative patient safety indicators

Cited by 14 publications

References 25 publications

Development of the Surgical Patient safety Observation Tool (SPOT)

Development of the Surgical Patient safety Observation Tool (SPOT)

Development and validation of a Self-assessment Instrument for Perioperative Patient Safety (SIPPS)

Implementation of anesthesia quality indicators in Germany

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