Information for Patients about PQIP
PERIOPERATIVE CARE is the care which patients receive when preparing for, undergoing and recuperating from surgery. PERIOPERATIVE MEDICINE aims to minimise the risk to patients of developing complications during and after surgery. The types of complication which may occur range from the relatively minor and short-lived, but which can be distressing to patients (for example, nausea and vomiting due to the type of anaesthesia or surgery) to very significant complications such as infection, bleeding or blood clots, which can cause longer-term harm. This risk of developing complications is specific to the individual patient, and will be dependent on their general health and fitness (less fit patients have a greater risk of complications) and also on the type of surgery they are having. There are a number of ways in which clinical teams and patients can work together to minimize the risk of harm and improve the management of medical illnesses that may occur around the time of surgery. Perioperative care involves input from several different teams, including anaesthesia, surgery, intensive care, general practice and many other allied specialties.
In the UK it is estimated that 10 million operations are performed in the NHS each year. Research data from both the UK and USA indicate the number of patients who develop complications or die after surgery varies between hospitals. Some of this variation may be due to differences in patient health and fitness; however some of it may be due to the care which patients receive in hospital, suggesting that there may be opportunities to improve standards, and therefore the results of surgery and patients’ long-term health and quality of life.
To address these issues, the Perioperative Quality Improvement Programme (PQIP) has been set up in 2016 by the NIAA Health Services Research Centre working on behalf of the Royal College of Anaesthetists. The aim of PQIP is to look at the way in which patients are treated around the time of major surgery, measure complication rates and patients’ perspectives on their care and recovery, and then report this information back to the NHS so that we can improve care for future patients. We will start this programme in a limited number of hospitals but aim to include all NHS hospitals over the next 5-10 years. The goal is to deliver real benefits to patients by supporting clinicians in using the data for improvement. We want to reduce surgical complication rates, improve patient experience and quality of life after surgery. So far about 70 hospitals have indicated that they would like to take part in the PQIP and it is supported by all the relevant professional medical and nursing bodies including the Royal College of Surgeons (England), the Royal College of Physicians, the Royal College of Nursing, the Faculty of Intensive Care medicine and the Faculty of Pain Medicine; we have also had patients involved in helping design our methods and plans from the outset.
We hope to reduce the variation and improve the quality of care for thousands of surgical patients. However, collecting all this information would be impossible if we included all surgical procedures. Therefore we will be assessing a random selection of five patients in each hospital taking part every week. By measuring the quality of care and how patients do after surgery in particularly high-risk surgical procedures, we hope to learn important lessons about how we can improve perioperative healthcare. An important part of the programme is that we will ask patients to provide information on their general health and well-being several time up to one year after their operation. This is very important, as we know that some patients who develop complications in hospital after surgery can have a reduced quality of life in the longer-term. Thus, understanding the patient perspective on their care, and learning how patients’ perceptions of their own recovery relate to perioperative risk factors and postoperative complications will further us to improve care for future patients.
In summary, prevention and management of different perioperative complications requires different strategies and demands input from many clinical specialties. Measuring and understanding the rates and reasons for post-operative complications is important for hospitals, so that they may target interventions aimed at addressing particular local issues and improving patient care and satisfaction.
Patient information leaflets, consent forms and questionnaires
Patient Questionnaire booklet
Patient Information Sheet
PQIP Patient Study Poster