A standardized set of metrics to assess the quality of anesthesia, perioperative care, and acute pain management in Canada: a multidisciplinary modified Delphi study.

Purpose: The aim of this study was to develop a consensus list of metrics to measure the quality of care in anesthesia, perioperative care, and acute pain management in Canada.

Methods: We sought to conduct a modified Delphi study involving a multidisciplinary panel of perioperative health care professionals (anesthesiologists, surgeons, nurses, internal medicine and family medicine physicians, and hospital administrators), patients, and caregivers. Participants reviewed a candidate list of metrics synthesized from a previous scoping review and performed three rounds of independent iterative scoring and feedback to achieve consensus. In round 3, we asked participants to identify priority metrics to include in a list of core metrics, and we also asked health care professionals to assess the feasibility of implementing each metric.

Results: There were 80 participants (49 health care professionals, 22 patients, and 9 caregivers) who completed at least one round of voting, with 56 completing all three rounds. The panel achieved consensus on 87 metrics, of which they deemed 33 to be priority core metrics. The health care professional and patient/caregiver subgroups differed in prioritizing core metrics. Most participants voted airway complications, no residual neuromuscular blockade, difficult airway documentation, complication or critical incident reporting, and complications from pain management the highest priority metrics. Most health care professional participants considered the core metrics to be already measured, currently feasible, or likely feasible by 2025.

Conclusions: A multidisciplinary panel developed a list of metrics for measuring the quality of anesthesiology care in Canada. Many metrics require further refinement and validation, and future research is required to guide the measurement techniques and implementation approaches.