Evidence map›Paper›PMID 41808519›Full record

SynthesisAnaesthesia2026

Quality indicators for structure and process in peri-operative care: a systematic review.

Sarah Kelly, Paige Cunnington, Harry Dunn, Isla Kuhn, Graham Martin, Mary Dixon-Woods, Oliver Boney, S Ramani Moonesinghe, Kristina Wanyonyi-Kay

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sarah KellyThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.
Paige CunningtonThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.
Harry DunnThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.
Isla KuhnThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.
Graham MartinThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.
Mary Dixon-WoodsThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.
Oliver BoneyDepartment of Anaesthesia and Peri-operative Medicine, University College London Hospitals NHS Foundation Trust, London, UK.
S Ramani MoonesingheDepartment of Anaesthesia and Peri-operative Medicine, University College London Hospitals NHS Foundation Trust, London, UK.
Kristina Wanyonyi-KayThe Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.

Funding

Health Foundation RG88620National Institute for Health and Care Research (NIHR) Central London Patient Safety Research Collaboration
6 · The paper itself

Abstract

introductionQuality indicators are essential for benchmarking, quality assurance and driving improvement in healthcare. Many indicators exist for peri-operative care but their relevance and evidence base vary. This systematic review updates a review published 10 years ago. It seeks to identify available structure and process indicators, and assess the level of evidence supporting them, with a view to informing the development of a core indicator set.

methodsMEDLINE, Embase, CINAHL and the Cochrane Library were searched. English-language studies in adults were included, alongside grey literature from: clinical, professional and governmental organisations; quality standards; and guidelines.

resultsThere were 657 included studies and grey literature sources, alongside indicators from a previously published review. Of a total 615 indicators (324 process indicators, 248 structure indicators and 43 indicators which were not defined clearly but relevant to process or structure), we identified 380 new indicators. Evidence supported 505 (82%) indicators, while 110 (18%) lacked clear evidence. This compared with 47% and 53%, respectively, in the previous review. Only 71 (12%) of the indicators were evaluated for validity. Inconsistencies were noted in definitions, with varying target thresholds reported for the same indicators. Many indicators were developed without the involvement of patients or carers. DISCUSSION: There is a need for standardisation in the development and naming of peri-operative quality indicators. Clear reporting, validation and patient involvement would improve their credibility and utility. Rationalising the current large, overlapping number of indicators is essential to enhance usability and ensure meaningful improvement in peri-operative care.

Indexed as

Perioperative CareQuality Indicators, Health CareHumansperi‐operative carequality indicatorsquality of health caresafety of health caresystematic review

Identifiers

PMID41808519
PMCPMC13352565

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.