• Katherine C Lee, Anne M Walling, Steven S Senglaub, Rachelle Bernacki, Lee A Fleisher, Marcia M Russell, Neil S Wenger, and Zara Cooper.
• Department of Surgery, University of California, San Diego, La Jolla, CA.
• Ann. Surg. 2022 Jan 1; 275 (1): 196202196-202.

ObjectiveDevelop quality indicators that measure access to and the quality of primary PC delivered to seriously ill surgical patients.Summary Of Background DataPC for seriously ill surgical patients, including aligning treatments with patients' goals and managing symptoms, is associated with improved patient-oriented outcomes and decreased healthcare utilization. However, efforts to integrate PC alongside restorative surgical care are limited by a lack of surgical quality indicators to evaluate primary PC delivery.MethodsWe developed a set of 27 preliminary indicators that measured palliative processes of care across the surgical episode, including goals of care, decision-making, symptom assessment, and issues related to palliative surgery. Then using the RAND-UCLA Appropriateness method, a 12-member expert advisory panel rated the validity (primary outcome) and feasibility of each indicator twice: (1) remotely and (2) after an in-person moderated discussion.ResultsAfter 2 rounds of rating, 24 indicators were rated as valid, covering the preoperative evaluation (9 indicators), immediate preoperative readiness (2 indicators), intraoperative (1 indicator), postoperative (8 indicators), and end of life (4 indicators) phases of surgical care.ConclusionsThis set of quality indicators provides a comprehensive set of process measures that possess the potential to measure high quality PC for seriously ill surgical patients throughout the surgical episode.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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