To help us monitor the quality of the care we provide, we measure what we do and how we do it. This allows us to establish standards of care and focus our improvement projects in the areas that will provide the greatest benefit to patients.
The three main levels to measuring outcomes include:
- Clinical outcomes
- Patient-reported outcomes
- Organisational focused outcome including financial outcome measures.
There is an abundance of healthcare data and on our National Outcomes page you will find a library of national audits. However, during the process of establishing our perioperative medicine service it has become apparent that it is vitally important to ensure what is measured is locally relevant.
When we started, our aims and therefore outcome measure were focused upon clinical outcomes. It was our desire to reduce post-operative complication rates that triggered the drive to establish the service. In our first year outcome measures were focused upon hospital length of stay, complication and mortality rates. As the servce developed, we quickly realised that we were failing to capture data that was relevant at a trust wide level. One example of this is patient flow, although we were capturing length of stay in each clinical area we were not truely capturing the effect of the service on access to critical care and discharge from recovery.
As the service continues to develop so does our refinement of what data to capture. Data is currently captured by the Perioperative Sepcialist Nurses but we also use surgical audit data and most recently data collected by the Perioperative Quailty Improvement Programme.
The data we are currently collecting is listed below, however this list in continuously under-review and we plan to expand this in the future to include more patient reported measures.
- Pre-operative assessment data
- Hospital length of stay
- Unplanned critical care admissions
- Perioperative protocol compliance
- Delayed discharge data
- Re-admission rates
- Post-operative morbidity scores on days 1,3,5,7 and 10
- Major and minor surgical complication rates
- 30 day, 90 day and 12 month mortality data
- Staff satisfaction