Summary of included QICs
| Main publication author (year) | Surgical condition | Study design (meets EPOC inclusion criteria Y/N) | Study aim | No of intervention sites | Outcome indicators | Process indicators | Other indicator |
| Peden (2019)22 30–32 34 | Emergency laparotomy | Stepped-wedge cluster RCT (Y) | Reduce postoperative mortality | 93, split into 15 clusters | 90-day/180-day mortality, postoperative LOS, 180-day readmission | Adherence to 10 metrics | – |
| Bamber (2019)25 33 | Emergency laparoscopic cholecystectomy | Controlled cohort evaluation (Y) | Reduce time to emergency cholecystectomy | 13, 1 withdrew | – | 8-day surgery rate | – |
| McNaney (2011)23 | Elective surgery | Controlled interrupted time series (Y) | Reduce postoperative length of stay (LOS) | 15, 1 withdrew | LOS, readmission, patient-reported outcome measures for hip and knee replacements | Day of surgery admission | Adoption of full implementation, patient experience |
| Aggarwal (2019)21 | Emergency laparotomy | Uncontrolled interrupted time series (Y) | Reduce postoperative mortality | 28 | Risk-adjusted and crude in-hospital mortality, LOS | Adherence to 6 metrics in care bundle | – |
| Tadd (2019)28 | Hip fracture | Controlled interrupted time series (N) | Improve care via guidance implementation | 6 recruited, 2 not included in analysis | 30-day mortality, LOS, readmission rate | Adherence to 23 metrics | Return to own home |
| McLeod (2003)26 | Elective day case surgery | Controlled interrupted time series (N) | Increase proportion of patients with a ‘to come in date’ | 24 (varying numbers in different analyses) | – | Proportion of patients with booked admission date, did not attends, proportion waiting ≥6 months | – |
| Potgieter (2012)19 | Elective abdominal aortic aneurysm repair | Uncontrolled before-and-after study (N) | Reduce postoperative mortality | 90, split into 12 regions | In-hospital mortality, LOS | Turn down rates | Case ascertainment |
| Kuper (2011)27 | Emergency and elective surgery | Uncontrolled before-and-after study (N) | Implement intraoperative oesophageal Doppler monitoring | 3 | LOS, postoperative stay, readmission rate, reoperation rate, inpatient mortality, oesophageal trauma, pulmonary oedema | Use of Doppler monitors | Volume/type of iv fluids, perioperative change in stroke volume, use of invasive monitoring |
| Huddart (2015)20 | Emergency laparotomy | Uncontrolled before-and-after study (N) | Reduce postoperative mortality | 4 | P-POSSUM risk-adjusted and crude 30-day mortality, in-hospital mortality | Adherence to 7 metrics in care bundle | – |
| Feinberg (2018)24 | Surgery for right iliac fossa pain | Uncontrolled before-and-after study (N) | Eliminate delay in operative management | 4 | Incision to discharge, LOS, 30-day readmission | Compliance with Royal College of Surgeons guidelines on time to surgery, admission to booking, booking to incision | – |
EPOC, Effective Practice and Organisation of Care; P-POSSUM, Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity; QICs, quality improvement collaboratives; RCT, randomised controlled trial.