Anaesthetic clinical indicators in public hospitals providing anaesthetic care in Hong Kong: prospective study

LL Lau, CT Hung, CK Chan, B Chow, PT Chui, B Ho, MC Kung, J Lui, T Hui, E Ho, S F Chan, H Y So
Department of Anaesthesia and Intensive Care, Tuen Mun Hospital, Tsing Chung Koon Road, New Territories, Hong Kong

OBJECTIVES. To assess the quality of anaesthetic services as defined in the six anaesthetic clinical indicators against preset standards and to identify risk factors for adverse events in the recovery room.

DESIGN. Prospective study.

SETTING. All public hospitals providing anaesthetic care in Hong Kong.

PATIENTS. Eighteen thousand, seven hundred and fifty-nine patients receiving elective or emergency anaesthesia administered by anaesthetists from June 1998 to July 1998.

MAIN OUTCOME MEASURES. Patient demographics, American Society of Anesthesiologists status, category and nature of operation, presence of preoperative anaesthetic visit in ward, type of anaesthesia, reasons for a recovery room stay of more than a 2-hour duration, intubation to relieve respiratory distress in the recovery room, presence of hypothermia in the recovery room for operations lasting more than 2 hours, and dental or ocular injuries attributable to anaesthesia.

RESULTS. There are two major findings from this study. Firstly, a high incidence of hypothermia in the recovery room was reported. Secondly, a greater risk of prolonged stay in the recovery room was identified for patients older than 65 years, major operations, and anaesthetic techniques using combined general and regional anaesthesia.

CONCLUSION. The six anaesthetic clinical indicators reflected the provision of anaesthetic care in public hospitals in Hong Kong. Good compliance to the preset standard of the anaesthetic clinical indicators was achieved during the study period.

Hong Kong Med J 2001;7:251-60

Key words: Anesthesia; Anesthesia recovery period; Quality assurance, health care; Risk management