Post-Operative Morbidity reporting using Visual Life Adjusted Displays (POM-VLAD)

More than 10 million operations take place in the NHS each year. Major and prolonged post-operative morbidity, for example significant infections, or respiratory or renal impairment, occurs in up to 15% of patients, and is associated with reduced long-term survival and poorer health-related quality of life.

The national Perioperative Quality Improvement Programme (PQIP) has been established with support from the Health Foundation to measure and report risk factors, processes and outcomes for patients undergoing major surgery across the UK. Currently, graphs of morbidity data are fed back to hospitals every three months without risk adjustment.

The Post-Operative Morbidity reporting using Visual Life Adjusted Displays (POM-VLAD) project will develop, implement and evaluate a novel, near-real-time reporting system (a visual life-adjusted display, or VLAD) for risk-adjusted morbidity (and mortality and failure to rescue rates if feasible) after major surgery.

The intervention will be piloted in 10 hospitals. The VLADs will be linked to guidance for clinicians on how to improve processes and outcomes. By developing a real-time display, clinicians will be able to visualise and more easily understand complex post-operative morbidity data. In addition, continuous feedback with guidance will allow local quality improvement activity to be better targeted, with the aim of reducing morbidity.

The first step will be to develop a risk adjustment model, based on data from the first year of the PQIP study. The team will then use this model to produce VLAD plots that display observed versus expected morbidity.

Contact information

For more information about this project, please contact Dr James Bedford, Anaesthetic & Intensive Care Medicine registrar, University College Hospital.