title: Perceptions about the relative importance of patient care-related topics: a single institutional survey of its anesthesiologists, nurse anesthetists, and surgeons.
abstract: BACKGROUND
  Persistently variable success has been experienced in locally translating even well-grounded national clinical practice guidelines, including in the perioperative setting. We have sought greater applicability and acceptance of clinical practice guidelines and protocols with our novel Perioperative Risk Optimization and Management Planning Tool (PROMPT™). This study was undertaken to survey our institutional perioperative clinicians regarding (a) their qualitative recommendations for (b) their quantitative perceptions of the relative importance of a series of clinical issues and patient medical conditions as potential topics for creating a PROMPT™.
  
  
  METHODS
  We applied a mixed methods research design that involved collecting, analyzing, and "mixing" both qualitative and quantitative methods and data in a single study to answer a research question. Survey One was qualitative in nature and asked the study participants to list as free text up to 12 patient medical conditions or clinical issues that they perceived to be high priority topics for development of a PROMPT™. Survey Two was quantitative in nature and asked the study participants to rate each of these 57 specific, pre-selected clinical issues and patient medical conditions on an 11-point Likert scale of perceived importance as a potential topic for a PROMPT™. The two electronic, online surveys were completed by participants who were recruited from the faculty in our Department of Anesthesiology and Perioperative Medicine and Department of Surgery, and the cohort of hospital-employed certified registered nurse anesthetists.
  
  
  RESULTS
  A total of 57 possible topics for a PROMPT™ was created and prioritized by our stakeholders. A strong correlation (r = 0.82, 95% CI: 0.71, 0.89, P < 0.001) was observed between the quantitative clinician survey rating scores reported by the anesthesiologists/certified registered nurse anesthetists versus the surgeons. The quantitative survey displayed strong inter-rater reliability (ICC = 0.92, P < 0.001).
  
  
  CONCLUSIONS
  Our qualitative clinician stakeholder survey generated a comprehensive roster of clinical issues and patient medical conditions. Our subsequent quantitative clinician stakeholder survey indicated that there is generally strong agreement among anesthesiologists/certified registered nurse anesthetists and surgeons about the relative importance of these clinical issues and patient medical conditions as potential topics for perioperative optimization and risk management.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Alabama School of Medicine, JT862, 619 19th Street South, Birmingham, AL, 35249-6810, USA. tvetter@uabmc.edu.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Vetter
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Alabama School of Medicine, JT862, 619 19th Street South, Birmingham, AL, 35249-6810, USA.
authors.forename: Joydip
authors.initials: J
authors.lastname: Barman
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Alabama School of Medicine, JT862, 619 19th Street South, Birmingham, AL, 35249-6810, USA.
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Boudreaux
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, University of Alabama School of Medicine, JT862, 619 19th Street South, Birmingham, AL, 35249-6810, USA.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Jones
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000592:standards; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009719:Nurse Anesthetists / Q000523:psychology* / Q000592:standards; D005791:Patient Care / Q000523:psychology* / Q000592:standards; D010820:Physicians / Q000523:psychology* / Q000592:standards; D011300:Preoperative Care / Q000523:psychology / Q000592:standards; D066231:Surgeons / Q000523:psychology* / Q000592:standards; D011795:Surveys and Questionnaires
keywords: Clinical care pathways; Healthcare outcomes; Patient-centered care; Perioperative care; Surgical home