Key points Value in health care is defined as patient-centered outcomes (PCOs) relative to the cost of achieving those outcomes. PCOs must consider the health trajectory well past discharge. Patient outcomes include that there is concordance of the expectations of…
Key Points A healthcare system can be viewed at micro, meso, or macrosystem levels. System thinking is a set of skills, behaviors, and tools that enable analysis of the processes interactions, perspectives, and boundaries of the system. Adopting a system-thinking…
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Key Points Large-scale audits have been hugely successful in gathering large volumes of data in short spaces of time to inform research and quality improvement (QI) endeavors and policy development. Built on the model of “citizen science,” they harness the…
Key points Because most improvements in perioperative care are incremental, large numbers of patients need to be studied to have adequate statistical power to detect a clinically important difference. Large, pragmatic, multicenter, randomized trials are more reliable because they provide…
Key Points Because of a paucity of randomized controlled trial (RCT) literature in perioperative medicine, well-designed “big data” studies can fill an important void. Robust, validated perioperative registries can be the foundation of research to inform perioperative practice patterns in…
Key Points Despite enormous strides in the reduction of intraoperative risk, the incidence of postoperative complications remains high and perioperative care is frequently fragmented. Significant variability in healthcare outcomes across different hospitals and hospital systems exists. Relatively new tools of…
Key Points Perioperative medicine is the medical care of patients undergoing surgery from the moment of contemplation of surgery until full recovery. The term “perioperative care” is increasingly used instead of perioperative medicine to emphasize the multidisciplinary nature of care…
Key points Psychological safety is essential for learning. Safety requires safe systems, not just individuals working safely. Involving patients in their own safety improves quality of care. John F Kennedy's quote describes our patient safety journey in the National Health…
Key Points The ultimate goal for any clinician and healthcare system is to deliver quality care. High quality care should be: safe, effective, timely and patient-centred. Quality improvement in medicine has proven to be challenging, complex and at times difficult…