PQIP Report 2021 - 2023
We are thrilled to bring you the fourth edition of the national Perioperative Quality Improvement Programme's Annual Report.
PQIP is a research study being led by the National Institute of Academic Anaesthesia Health Services Research Centre, working on behalf of the RCoA and a range of stakeholders. PQIP has continued to work towards reducing the risk of complications after major surgery through ensuring that patients get the best possible care throughout their perioperative pathway. It is wonderful to see more hospitals than ever collecting patient data and thousands of patients providing their own feedback on satisfaction with care and longer-term quality of life. PQIP’s work is a benefit to teams across the country, giving them the opportunity to act on their own quality data and helping them to improve the quality of the perioperative pathway for their patients.
A letter from Jenny Dorey (Patient and Public involvement representative) and Ramani Moonesinghe (PQIP Chief Investigator):
"We are delighted to bring you the fourth PQIP Cohort report. At the time of writing, over 46,000 patients have
been recruited and we present here data from 44,114 patients who have completed their primary episodes of care
after major non-cardiac surgery. Almost 12,000 new patients’ data are analysed in our fourth Cohort, an amazing
achievement given the continued difficulties faced by clinicians, researchers and patients since the pandemic.
There are three key themes running through this report. The first is our renewed focus on reducing complications
and length of stay after surgery, not just because it is good for individual patients, but because it is essential
for NHS recovery after the pandemic. To do this, we need efficient, high quality, reliable patient care delivered
through individualised, but evidence-based and protocolised pathways. This leads us to the second of our
themes – simplifying enhanced recovery. Since our last Cohort report, the publication of PQIP research on
the association between Drinking, Eating and Mobilising (DrEaMing) within 24h of surgery and later outcomes,
has led to changes in national policy and improvements in clinical practice. Our third, and perhaps most
important theme, is to promote teamwork, including with patients. Improvements in care cannot be delivered
by lone heroes. We advocate for using the full capacity of the Multi-Disciplinary Team (MDT), starting with
communication of your own Trust’s results to them, as well as this report, highlighting its recommendations.
Our top five priorities for the coming year reflect these themes. Individualised risk assessment is again
highlighted as the foundation of high-quality patient care. Focusing on DrEaMing within 24h, and the factors
which support this, is again a key priority. We now know that preoperative anaemia and severe postoperative
pain are risk factors for failure to DrEaM within 24h. Individualised pain management and Patient Blood
Management are therefore identified as additional priorities. Finally, embedding PQIP into your day-today
MDT working provides the basis for your improvement efforts. We have showcased new PQIP initiatives
to support this – including the launch of the pomVLAD (risk adjusted postoperative morbidity) dashboard in
colorectal surgery, updated Quality Improvement dashboards in all other types of surgery, and top tips on patient
engagement and quality improvement.
Thank you as always to our PQIP collaborators who work so hard to recruit patients, input data and use the data
to improve care. Thank you too, to the tens of thousands of patients who have trusted us with their information for
PQIP research. And finally, thank you for reading this report and taking action on its recommendations."
