Vigilance indicators in surgery

Context

Within the framework of a hospital reform relating to the system of authorizations for healthcare activities, the French Ministry of Health requested that the National Authority for Health define surgery vigilance indicators and methods for implementation to improve patient safety and quality of care. If a quality or safety issue is identified, authorization maintenance or renewal of surgical activities will be conditional on the hospital’s participation in the implementation of improvement actions.

To avoid an additional burden for hospitals, vigilance indicators had to be calculated from medico-administrative databases.

 

What are vigilance indicators?

These are screening tools to help professionals identify areas of potential concern, via alert thresholds which detect outlier results. An outlier status must automatically trigger further analysis and investigation with a review of factors that may have an impact on the delivery of care and patient outcomes.

 

Method

A non-systematic international literature search was conducted in 2021 to identify:

• outcome indicators relating to the quality and safety of care in 13 surgical specialties (mainly from specialized websites of institutions producing indicators and, for surgical specialties where few indicators were found, from automated bibliographic databases);

• methods for implementing vigilance indicators.

An analysis was then carried out by the French Technical Agency for Information on Hospital Care to assess which indicators could be calculated from the national hospital discharge database.

Among the calculable indicators, stakeholders from the 13 surgical specialties were asked to select the 5 most relevant indicators from a clinical point of view and for the improvement of practices.