A Delphi process to define medical reporting outcomes for urgent surgical pathways

Area of Science:

• Healthcare Quality Assessment
• Surgical Outcomes Research
• Medical Informatics

Background:

• Growing demand for high-quality healthcare necessitates standardized methods for hospital care assessment.
• Current lack of standardization hinders comparison of urgent surgical outcomes across studies.
• A modified Delphi methodology was employed to define essential reporting outcomes for urgent surgical care.

Purpose of the Study:

• To establish a consensus-driven set of outcomes for evaluating urgent surgical care.
• To address the need for standardized metrics in comparing urgent surgical outcomes.
• To inform the development of new prioritization policies for urgent surgeries.

Main Methods:

• A three-round modified Delphi process involving an international panel of medico-surgical experts (May-October 2024).
• Selection of reporting outcomes for urgent surgical pathways based on a two-level consensus assessment.
• Inclusion of experts from 16 countries to ensure a global perspective.

Main Results:

• An initial 87 items across 8 headings were refined to 29 selected outcomes.
• Key outcomes include mortality, perioperative morbidity, and patient journey factors (preoperative, intraoperative, postoperative).
• Patient satisfaction and medico-economic criteria were excluded; multi-criteria outcomes were deemed essential.

Conclusions:

• A standardized set of 29 outcomes provides a comprehensive approach to urgent surgical care evaluation.
• These outcomes facilitate better study of urgent surgery results and development of prioritization policies.
• Notably, economic criteria and patient satisfaction measures were not retained in the final outcome set.