Table 2

Summary of included QICs

Main publication author (year)Surgical conditionStudy design (meets EPOC inclusion criteria Y/N)Study aimNo of intervention sitesOutcome indicatorsProcess indicatorsOther indicator
Peden (2019)22 30–32 34Emergency laparotomyStepped-wedge cluster RCT (Y)Reduce postoperative mortality93, split into 15 clusters90-day/180-day mortality, postoperative LOS, 180-day readmissionAdherence to 10 metrics
Bamber (2019)25 33Emergency laparoscopic cholecystectomyControlled cohort evaluation (Y)Reduce time to emergency cholecystectomy13, 1 withdrew8-day surgery rate
McNaney (2011)23Elective surgeryControlled interrupted time series (Y)Reduce postoperative length of stay (LOS)15, 1 withdrewLOS, readmission, patient-reported outcome measures for hip and knee replacementsDay of surgery admissionAdoption of full implementation, patient experience
Aggarwal (2019)21Emergency laparotomyUncontrolled interrupted time series (Y)Reduce postoperative mortality28Risk-adjusted and crude in-hospital mortality, LOSAdherence to 6 metrics in care bundle
Tadd (2019)28Hip fractureControlled interrupted time series (N)Improve care via guidance implementation6 recruited, 2 not included in analysis30-day mortality, LOS, readmission rateAdherence to 23 metricsReturn to own home
McLeod (2003)26Elective day case surgeryControlled 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)19Elective abdominal aortic aneurysm repairUncontrolled before-and-after study (N)Reduce postoperative mortality90, split into 12 regionsIn-hospital mortality, LOSTurn down ratesCase ascertainment
Kuper (2011)27Emergency and elective surgeryUncontrolled before-and-after study (N)Implement intraoperative oesophageal Doppler monitoring3LOS, postoperative stay, readmission rate, reoperation rate, inpatient mortality, oesophageal trauma, pulmonary oedemaUse of Doppler monitorsVolume/type of iv fluids, perioperative change in stroke volume, use of invasive monitoring
Huddart (2015)20Emergency laparotomyUncontrolled before-and-after study (N)Reduce postoperative mortality4P-POSSUM risk-adjusted and crude 30-day mortality, in-hospital mortalityAdherence to 7 metrics in care bundle
Feinberg (2018)24Surgery for right iliac fossa painUncontrolled before-and-after study (N)Eliminate delay in operative management4Incision to discharge, LOS, 30-day readmissionCompliance 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.