Anesthesia Core Quality Metrics Consensus Delphi Study

Study Overview
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Brief Summary
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To develop a ranked list of up to 20 metrics, which can be used to evaluate the quality of anesthesia, perioperative care, and acute pain management for adult inpatient non-cardiac surgical patients for use in quality improvement and quality assurance, research, and continuing medical education in the Canadian care context.

Detailed Description
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Background: Improving anesthesiology care and perioperative outcomes is a growing field encompassing quality improvement and quality assurance, research, and continuing medical education. Multiple consensus initiatives have standardized perioperative endpoints. However, no standard set of metrics exist to evaluate the quality of Canadian anesthesiology care delivery. Objective: Develop a ranked list of up to 20 metrics, which can be used to evaluate the quality of anesthesia, perioperative care, and acute pain management for adult inpatient non-cardiac surgical patients for use in quality improvement and quality assurance, research, and continuing medical education in the Canadian care context. Methods: First, the steering committee will conduct a scoping review of the literature to identify candidate metrics, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) and Joanna Briggs Institute methodology for scoping reviews. Metrics will include patient-reported outcome and patient-reported experience measures, quality and safety indicators, process metrics, and Canadian Anesthesiologists' Society recommended practice standards. The search strategy will include English-language articles published or in use within the past seven years (2015/Jan-2022/March) in 1) MEDLINE, Embase, CINAHL, Web of Science, and Cochrane Database of Systematic Reviews, 2) grey literature, including guidelines, and 3) existing evaluation metrics used by Canadian departments for quality assurance and improvement. Screening and data extraction will be performed by two independent reviewers using Covidence. Next, following approval from the Research Ethics Board and with written informed consent from participants, a multidisciplinary panel of anesthesiologists, people with lived surgical experience (patients, caregivers), surgeons, nurses, internal medicine and family physicians, hospital administrators, and researchers will iteratively review the list of candidate metrics using a modified Delphi process. Independent voting, using surveys over three rounds, will be used to identify the most important metrics to define the quality of anesthesia, perioperative care, and acute pain management. Additional cycles may be performed if required.

Official Title
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Development of a Standardized Set of Core Metrics to Assess the Quality of Anesthesia, Perioperative Care, and Acute Pain Management in Canada: Scoping Review and Multidisciplinary Consensus Delphi Study

Conditions
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Anesthesia, Consensus Development

Intervention / Treatment
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* Other: Modified Delphi process


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient/family participants must have undergone a surgical experience within the past three years, and have the capacity to provide informed consent. All other participants must be actively practising in Canada in the disciplines they represent. Exclusion Criteria: - Participants with self-declared conflicts of interest with this project.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study participants<br>Study participants | Other: Modified Delphi process<br>* The study involves a brief demographics survey and Delphi process, i.e. three rounds of information and surveys, in which participants will be asked to score/rank potential metrics.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ranked list of anesthesia, perioperative care, and acute pain management quality metrics | A ranked set of national consensus metrics for evaluating the quality of anesthesia, perioperative care, and acute pain management for adult noncardiac surgical patients that can be used for quality improvement and quality assurance, research, and continuing medical education in the Canadian care context. Metrics where >70% participants voted definitely priority will be marked in the publication as the core metric set. | late 2022 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Metrics, Perioperative care, Quality of anesthesia, Outcomes, Delphi