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In progress

Developing a perioperative core process and structure indicator set


Almost 10 million people have surgery in the UK every year. To achieve the best outcomes of surgery, perioperative care –  covering care  before, during, and after a surgical procedure, from the time patients start thinking about surgery to when they recover afterwards – plays a key role.  

Perioperative care needs to be good quality. So it’s important to have quality indicators along the perioperative pathway that can help in making the standards clear and assessing what happens in practice.

Many quality indicators are already used in perioperative care. Some of them measure aspects of structure (such as the availability of equipment). Some measure healthcare processes (such as post-surgery pain management). And some measure outcomes (such as length of stay after surgery). But not all of indicators of structure and process in current use have strong evidence supporting them, and input from patients or healthcare staff about which indicators they think are the most important has been lacking.

We want to develop a standard set of good quality indicators relevant to structure and processes in perioperative care that can be used in monitoring, evaluation and research. We’ll do this collaboratively with patients and staff, and at the same time refine the methodology for developing these kinds of indicator sets.


We will use a three-step approach.

  • We will start by updating and examining the current literature on quality indicators for perioperative care already in use and the evidence supporting them. We’ll also create a conceptual framework to help organise the indicators into different aspects of quality and safety.
  • An expert collaborative group (ECG) including perioperative care specialists, patients, and carers along with other healthcare professionals and healthcare managers, will review the indicators and the conceptual framework. They will then choose the indicators which they think should be included in a wider online consultation. The online consultation exercise will involve up to 400 people and help to decide which indicators are most important – and how they should be prioritised.
  • A final consensus meeting involving the ECG will consider the findings and confirm the final indicator set.

Funding and ethics

This study is funded by the Health Foundation’s grant to The Healthcare Improvement Studies Institute (THIS Institute). It is independently led by THIS Institute.

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