Indicator definitions, data collection methods and proposed targets
| Measure | Domain covered | Data collection | Definition | Target |
| Data source: Hospital administrative data | ||||
| Morbidity and mortality conference | Safe structure | Retrospective | Morbidity and mortality meeting conducted, documented as conducted | Minimum of 9 per year |
| POMR | Safe outcome | Retrospective from patient charts | Total number of inhospital deaths of patients who underwent a surgical procedure during the same admission over the total number of surgical procedures performed in the same time period | 1%–2% |
| Readmission rate within 30 days | Effective outcome | Retrospective from patient charts | Percentage of patients who had a readmission to the study site within 30 days of their surgery | <10% |
| Data source: OR logbook | ||||
| Proceduredensity | Effective process | Retrospective | Number of surgical cases performed in the OR/population of catchment area 100 000 | 5000 cases/100 000 population |
| Daily OR usage | Efficient process | Retrospective | Total usage/total available time across all OR. Usage was estimated from entry to exit of patient to the OR plus 30 min of turnover time. Availability was defined as time between start of the first case and end of the last case of the day, 7 days a week | 85% |
| Data source: Modified intraoperative checklist delivered by researcher | ||||
| Safe surgery checklist use | Safe process | Prospective | Proportion of surgical cases performed in the OR as per full WHO safe surgery checklist. Specific use of pulse oximetry, patient name band and intraoperative antibiotics | 100% |
| Use of consent | Patient-centred process | Prospective | Proportion of cases performed in the OR with signed informed consent, paperwork or documentation that informed consent was obtained or unable to be obtained due to patient condition | 100% |
| Hours from ED arrival to non-elective abdominal surgery | Timely process | Prospective | Mean (time of incision − time of arrival in ED) for non-elective abdominal cases | <24 hours |
| Fully qualified surgeon present | Effective structure | Prospective | Per cent of surgeries performed with an attending surgeon present | 100% |
| Data source: Patient discharge survey delivered by researcher | ||||
| Patient hospital satisfaction questionnaire | Patient-centred outcome | Prospective | Mean total score on HCAHPS survey | ‘Top box response rate’ 70% across all fields |
| Travel time to hospital | Timely structure | Prospective | Proportion of patients reporting having travelled <2 hours to reach the hospital | 80% |
| Follow-up plan | Timely outcome | Prospective | Proportion of patients answering yes to ‘Have you received instructions on how you will receive continuing care?’ | 100% |
| Mean income compared with mean catchment income (or GDP/capita) | Equitable structure | Prospective | Mean income determined on patient exit interview/mean income of catchment population or GDP per capita | ≤1 |
| Proportion of patients experiencing catastrophic expenditure | Equitable outcome | Prospective | Proportion of patients where sum of total self-reported expenditure/self-reported income is >40% | 0% |
ED, emergency department; GDP, gross domestic product; HCAHPS, Hospital Consumer Assessment of Healthcare Providers and Systems; OR, operating room; POMR, perioperative mortality rate.