The Perioperative Quality Improvement Programme (PQIP patient study): protocol for a UK multicentre, prospective cohort study to measure quality of care and outcomes after major surgery
Ramani Moonesinghe, Dermot McGuckin, Peter Martin, James Bedford, Duncan Wagstaff, David Gilhooly, Cristel Santos, Jon Wilson, J. Dorey, Irene Leeman, Helena Smith, Cecilia Vindrola‐Padros, Kylie Edwards, Georgina Singleton, Michael Swart, Rachel Baumber, Arun Sahni, Samantha Warnakulasuriya, Ravi Vohra, Helen Ellicott, Anne‐Marie Bougeard, Maria Chazapis, Aleksandra Ignacka, M. Christine Cripps, Alexandra Brent, Sharon Drake, James Goodwin, Peter Martin, Karen Williams, Pritam Singh, Matthew Bedford, Abigail Vallance, Katie Samuel, Jose Lourtie, Dominic Olive, Christine Taylor, Olga Tucker, Giuseppe Aresu, Andrew Swift, Naomi Fulop, Mike Grocott, Ramani Moonesinghe, Giuseppe Aresu, Rachel Baumber, James Bedford, Matthew Bedford, Alexandra Brent, Maria Chazapis, Jake Comish, M. Christine Cripps, J. Dorey, Sharon Drake, Naomi Fulop, David Gilhooly, James Goodwin, Mike Grocott, Irene Leeman, Peter Martin, Claire McCann, Dermot McGuckin, Leila Nasser, Arun Sahni, Pritam Singh, Helena Smith, Chris Snowden, John Stones, M. Swart, Olga Tucker, Abigail Vallance, Cecilia Vindrola‐Padros, Ravi Vohra, Duncan Wagstaff, Karen Wiliams, Jon Wilson, J F Abercrombie, Suhail Anwar, Anna Bachelor, Stephen J. Brett, T. Justin Clark, Graham Cooper, Anna Crossley, Jugdeep Dhesi, Marie Digner, Elspeth Evans, Mark Hamilton, Robert Hill, Zoe Huish, Ravi Mahajan, Dave Murray, Monty Mythen, Jonathan McGhie, John McGrath, Samantha Shinde, Mark Speakman, Andrew Swift, Emma Vaux
Abstract
INTRODUCTION: Major surgery accounts for a substantial proportion of health service activity, due not only to the primary procedure, but the longer-term health implications of poor short-term outcome. Data from small studies or from outside the UK indicate that rates of complications and failure to rescue vary between hospitals, as does compliance with best practice processes. Within the UK, there is currently no system for monitoring postoperative complications (other than short-term mortality) in major non-cardiac surgery. Further, there is variation between national audit programmes, in the emphasis placed on quality assurance versus quality improvement, and therefore the principles of measurement and reporting which are used to design such programmes. METHODS AND ANALYSIS: The PQIP patient study is a multi-centre prospective cohort study which recruits patients undergoing major surgery. Patient provide informed consent and contribute baseline and outcome data from their perspective using a suite of patient-reported outcome tools. Research and clinical staff complete data on patient risk factors and outcomes in-hospital, including two measures of complications. Longer-term outcome data are collected through patient feedback and linkage to national administrative datasets (mortality and readmissions). As well as providing a uniquely granular dataset for research, PQIP provides feedback to participating sites on their compliance with evidence-based processes and their patients' outcomes, with the aim of supporting local quality improvement. ETHICS AND DISSEMINATION: Ethical approval has been granted by the Health Research Authority in the UK. Dissemination of interim findings (non-inferential) will form a part of the improvement methodology and will be provided to participating centres at regular intervals, including near-real time feedback of key process measures. Inferential analyses will be published in the peer-reviewed literature, supported by a comprehensive multi-modal communications strategy including to patients, policy makers and academic audiences as well as clinicians.