Standardised metrics for global surgical surveillance

• Published in: The Lancet (British edition) Vol. 374; no. 9695; pp. 1113 - 1117
• Main Authors: Weiser, Thomas G, MD, Makary, Martin A, MD, Haynes, Alex B, MD, Dziekan, Gerald, MD, Berry, William R, MD, Gawande, Atul A, Dr
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 26.09.2009; Elsevier; Elsevier Limited
• Subjects: Biological and medical sciences; Colleges & universities; Data Collection; General aspects; Health Policy; Health services; Health surveillance; Hospital Mortality; Hospitals; Humans; Infant mortality; Internal Medicine; Internationality; Life expectancy; Medical sciences; Patient safety; Public health; Quality Indicators, Health Care - statistics & numerical data; Resource allocation; Safety programs; Surgical Procedures, Operative - mortality; Surgical Procedures, Operative - standards; Surgical Procedures, Operative - statistics & numerical data; Medicine; Treatment; Surveillance; Surgery; Standardization
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(09)61161-2

Summary Public health surveillance relies on standardised metrics to evaluate disease burden and health system performance. Such metrics have not been developed for surgical services despite increasing volume, substantial cost, and high rates of death and disability associated with surgery. The Safe Surgery Saves Lives initiative of WHO's Patient Safety Programme has developed standardised public health metrics for surgical care that are applicable worldwide. We assembled an international panel of experts to develop and define metrics for measuring the magnitude and effect of surgical care in a population, while taking into account economic feasibility and practicability. This panel recommended six measures for assessing surgical services at a national level: number of operating rooms, number of operations, number of accredited surgeons, number of accredited anaesthesia professionals, day-of-surgery death ratio, and postoperative in-hospital death ratio. We assessed the feasibility of gathering such statistics at eight diverse hospitals in eight countries and incorporated them into the WHO Guidelines for Safe Surgery, in which methods for data collection, analysis, and reporting are outlined.