Which clinical anesthesia outcomes are both common and important to avoid?The perspective of a panel of expert anesthesiologists

Anesthesia groups may need to determine which clinical anesthesia outcomes to track as part of quality improvement efforts. The goal of this study was to poll a panel of expert anesthesiologists to determine which clinical an esthesia outcomes associated with routine outpatient surgery were judged to occur frequently and to be important to avoid. Outcomes scoring highly in both scales could then be prioritized for measurement and improvement in am bulatory clinical practice. A mailed survey instrument instructed panel mem bers to rate 33 clinical anesthesia outcomes in two scales: how frequently they believe the outcomes occur and which outcomes they expect patients fin d important to avoid. A feedback process (Delphi process) was used to gain consensus rankings of the outcomes for each scale. Importance and frequency scores were then weighted equally to qualitatively rank order the outcomes . Of the 72 anesthesiologists, 56 (78%) completed the questionnaire. The fi ve items with the highest combined score were (in order): incisional pain, nausea, vomiting, preoperative anxiety, and discomfort from TV insertion. T o increase quality of care, reducing the incidence and severity of these ou tcomes should be prioritized. Implications: Expert anesthesiologists reache d a consensus on which low-morbidity clinical outcomes are common and impor tant to the patient. The outcomes identified may be reasonable choices to b e monitored as part of ambulatory anesthesia clinical quality improvement e fforts.