American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on...

Area of Science:

• Perioperative Medicine
• Health Services Research
• Patient-Reported Outcomes

Background:

• Enhanced recovery pathways (ERPs) traditionally focus on clinical outcomes like complications and length of stay.
• These metrics often neglect patient-centered outcomes such as functional status and well-being post-discharge.
• Patient-reported outcomes (PROs) offer a valuable, yet underutilized, perspective in perioperative care.

Purpose of the Study:

• To establish best practices for integrating PROs into ERPs.
• To develop consensus guidelines for collecting and utilizing PRO data in surgical recovery.
• To enhance the quality of care by incorporating patient perspectives.

Main Methods:

• An expert panel (Perioperative Quality Initiative - POQI) conducted a literature review.
• A modified Delphi method was employed to reach consensus on clinical questions.
• Recommendations were developed based on evidence and expert opinion.

Main Results:

• PROs should encompass physical, mental, and social domains.
• Data collection should occur preoperatively, postoperatively, and after discharge (30 and 90 days).
• Specific PRO measures recommended include Quality of Recovery-15 (postoperative) and WHO Disability Assessment Scale 2.0 or PROMIS (post-discharge).

Conclusions:

• Integrating PROs into ERPs provides a more comprehensive view of surgical recovery.
• PROs can facilitate shared decision-making and benchmark recovery goals.
• Further research is needed to define the role of PROs in evaluating quality and guiding perioperative care.