Quality indicators for anesthesia and perioperative medicine

Abstract

Purpose of reviewRoutine monitoring of care quality is fundamental considering the high reported rates of preventable perioperative morbidity and mortality. However, no set of valid and feasible quality indicators is available as the gold standard for comprehensive routine monitoring of the overall quality of perioperative care. The purpose of this review is to describe underlying difficulties, to summarize current trends and initiatives and to outline the perspectives in support of suitable perioperative quality indicators.Recent findingsMost perioperative quality indicators used in the clinical setting are based on low or no evidence. Evidence-based perioperative quality indicators validated for research purposes are not always applicable in routine care. Developing a core set of perioperative quality indicators for clinical practice may benefit from matching feasible routine indicators with evidence-based indicators validated for research, from evaluating additional new indicators, and from including patients’ views.SummaryA core set of valid and feasible quality indicators is essential for monitoring perioperative care quality. The development of such a set may benefit from matching evidence-based indicators with feasible standard indicators and from including patients’ views.

The way towards ethical anesthesia care: no aim – no game – no fame or blame?

“…Patient safety is a core principle in anesthesia practice and anesthesiologists are the leaders in focusing on patient safety and implementing standards of care [35]. Patient safety stands as a fundamental principle within the realm of anesthesia practice.…”

Precision Anaesthesia: Advancing Patient-Centered Precision Care Through Repetitive Assessment of PROMs with the Safe Brain Initiative Approach

“…However, these outcomes are often monitored sporadically or superficially, neglecting the crucial need for continuous quality enhancement and precision in anaesthesia care. 10 When the assimilation of individual and local patient outcome data is omitted, healthcare professionals forfeit a realistic appraisal of their individual or departmental methodologies' efficacy. Moreover, the lack of structured, anonymous individual feedback deviates from the primary goal of anaesthesia: prioritising patient well-being.…”

Safety, professionalism and excellence in Anesthesiology

“…[1][2][3][4] Despite the fear that patients have of anesthesia 5,6 this is one of the safest specialties due to the growth in technologies such as automation, artificial intelligence, in basic sciences, in communication-teaching, in novel approaches, and in the professionalism of anesthesiologists. 7,8 Mortality due to anesthesia is 1:100,000, although anesthetic management can cause non-fatal complications that negatively modify the evolution of patients and the cost of health services. This figure is variable depending on the age, the type of surgery, the physical condition of the patients, the anesthetic-surgical environment, etcetera.…”

“…In some places it is necessary to have 1 to 3 years of formal training in internal medicine and there are subspecialties of anesthesia such as pediatrics, cardiothoracic, obstetric, neuro, critical care, pain, regional anesthesia, bariatrics, hospice and palliative medicine, and other areas that require 1 to 3 more years of formal training residency or fellowship. 8,10,11 In contrast, it is increasingly common to find training centers in secondary level hospitals that do not meet the minimum necessary to create specialists, or the anesthesiologists graduated from these sites finishes his/her specialty with deficiencies that may be significant in their future professional practice. Fortunately, most of these colleagues continue their training and update themselves day by day, seeking excellence in their profession that guarantees safe perioperative care.…”