National quality improvement indicators project: an initial descriptive study

Area of Science:

• Anesthesiology
• Healthcare Quality Improvement
• Hospital Performance Metrics

Background:

• Anaesthesia Quality Improvement New Zealand (AQINZ) established five key quality indicators for postoperative care: nausea/vomiting, pain, respiratory distress, hypothermia, and prolonged post-anaesthesia care unit (PACU) stay.
• Assessing the feasibility of data collection and national estimation of these indicators was crucial for quality monitoring.

Purpose of the Study:

• To determine the proportion of eligible New Zealand institutions capable of measuring AQINZ quality indicators.
• To establish initial national estimates for these indicators.
• To quantify the variability in quality improvement indicator performance across New Zealand hospitals.

Main Methods:

• Inclusion criteria: All public hospitals represented by AQINZ.
• Data collection: Participating hospitals reported patient numbers and proportions for each of the five indicators over a two-week period (June 1 - October 25, 2019).
• Analysis: Calculated overall and median percentages for each indicator, alongside measures of variability (interquartile range).

Main Results:

• A high participation rate of 79.2% of eligible hospitals was achieved.
• Median indicator incidence varied from 1.67% (respiratory distress) to 6.31% (prolonged PACU stay).
• Significant variability was observed for prolonged PACU stay, hypothermia, pain, and postoperative nausea and vomiting, with respiratory distress showing the lowest variability.

Conclusions:

• Most New Zealand institutions can successfully measure and report on the specified anesthesia quality indicators.
• Respiratory distress demonstrates consistently low incidence and variability.
• Substantial variation exists in other key indicators, necessitating further investigation into the underlying causes.