Perioperative Quality Improvement Programme (PQIP) publishes first annual report

Royal College of Anaesthetists |Perioperative Quality Improvement Programme | April 2018

The Perioperative Quality Improvement Programme (PQIP) has published its first Annual Report.  The study led by the National Institute of Academic Anaesthesia Health Services Research Centre, on behalf of the Royal College of Anaesthetists (RCoA) and a range of stakeholders, with the aim of improving patient outcomes from major surgery.

Since PQIP’s inception in 2017, over 6,500 patients have been recruited from 79 hospitals across England.  The report outlines PQIP’s five national improvement opportunities for 2018-19.  Among them are: a focus on individualised risk assessment, adherence to enhanced recovery principles,  implementation and adherence to enhanced recovery pathways,  and the optimisation of anaemia, diabetes, and postoperative pain.


Dr Liam Brennan, President of the RCoA, said:  “PQIP demonstrates that while there are pockets of excellence across the NHS, no hospital as yet offers a complete perioperative medicine package for every patient. All hospitals are encouraged to participate in this programme to enhance the delivery of perioperative care across the whole of the NHS .” (Royal College of Anesthetists)

The full press release from the Royal College of Anesthetists can be read here 

More details can be found at PQIP’s website 

The full report can be read here 


Measuring and Improving the Quality of Preprocedural Assessments

Preprocedural assessments are used by anesthesia providers to optimize perioperative care for patients undergoing invasive procedures | Anesthesia & Analgesia


When these assessments are performed in advance by providers who are not caring for the patient during the procedure, there is an additional layer of complexity in ensuring that the workup meets the needs of the primary anesthesia care team. In this study, anesthesia providers were asked to rate the quality of preprocedural assessments prepared by other providers to evaluate anesthesia care team

The overwhelming majority of preprocedural assessments performed at our institution were considered satisfactory or exemplary by day-of-surgery anesthesia providers. This was demonstrated by both the case-by-case ratings and midpoint survey. However, the perceived frequency of “unsatisfactory” evaluations was worse when providers were asked to reflect on the quality of preprocedural evaluations generally versus rate them individually. Analysis of comments left by providers allowed us to identify specific and actionable areas for improvement. This method can be used by other institutions to identify systemic deficiencies in the preprocedural evaluation process.

Full reference: Manji, F. et al. (2017) Measuring and Improving the Quality of Preprocedural Assessments. Anesthesia & Analgesia. 124(6 ) pp. 1846–1854

Quality Improvement Program Reduces Respiratory-Related Events

According to data presented at the 2017 annual meeting of the Society for Technology in Anesthesia, implementation of a hospital-based quality improvement program (QIP) was shown to reduce respiratory-related events after only one year | Clinical Anesthesiology

Although the program did not lead to changes in PSI-11 (Patient Safety Indicator 11), ICU transfers or mortality, continuous monitoring with capnography and pulse oximetry was associated with reductions in postoperative respiratory failure, cardiac arrest/resuscitation events and length of stay from a respiratory event.

“We implemented this program because it was the right thing to do for our patients,” said Christine O’Farrell, BSN, CPHQ, CPHRM, director of quality management for Barton Healthcare, in South Lake Tahoe, Calif., “but these data suggest that continuous monitoring with both capnography and pulse oximetry may improve quality by reducing severe respiratory adverse events and length of stay for high-risk patients.”

Read the full overview here

Patient reported outcome of adult perioperative anaesthesia

Walker, E.M.K. et al. (2016) British Journal of Anaesthesia. 117 (6) pp. 758-766.


Background. Understanding the patient perspective on healthcare is central to the evaluation of quality. This study measured selected patient-reported outcomes after anaesthesia in order to identify targets for research and quality improvement.

Conclusions. Anxiety and discomfort after surgery are common; despite this, satisfaction with anaesthesia care in the UK is high. The inconsistent relationship between patient-reported outcome, patient experience and patient satisfaction supports using all three of these domains to provide a comprehensive assessment of the quality of anaesthesia care.

Read the full abstract here