A64 Can Quality be measured in Neuroanaesthesia?

Abstract

Background: In 2008 the NHS published ‘High Quality Care for All: NHS Next Stage Review final report’ (Lord Darzi). This report described the concept of defining and measuring quality and has been promoted as the primary ethos driving the NHS. Staff at all levels should be able to measure services provided and improve the quality of care they deliver. They should also be able to provide patients with assurance that standards are monitored. Method: In 2009 the NHNN introduced quality measures across 31 subspecialties including neuroanaesthesia. Our department was asked to select 4 measures that defined quality of care for patients undergoing general anaesthesia for neurosurgery. The measures chosen by our department were: Pre-operative anaesthetic assessment to include cardiovascular risk Patient experience in the induction room World Health Organisation Safe Surgery Checklist compliance Post-operative pain score on leaving the recovery ward of 1 or less (range 0–4) We were required to set targets for these indicators and audit at regular intervals. The results of these audits would then inform local change and allow improvements to be made quickly. Results: Results have been collated over a 2 year period as shown in Table 1 (Quality Scorecard Results). Where targets were not met local improvement measures were put in place.Conclusion: As scorecards have become embedded in our department, we have learnt how to quantify the quality of the service offered to our patients. More importantly, we have learnt how to use this scorecard effectively to introduce change at a local level. This encourages leadership from the ‘bottom up’ allowing change to be responsive and locally driven. References High Quality Care for All: NHS next stage review final report. Lord Darzi, June 2008