Background: Persistently variable success has been experienced in locally translating even well-grounded national\nclinical practice guidelines, including in the perioperative setting. We have sought greater applicability and acceptance\nof clinical practice guidelines and protocols with our novel Perioperative Risk Optimization and Management Planning\nTool (PROMPTââ??¢). This study was undertaken to survey our institutional perioperative clinicians regarding (a) their\nqualitative recommendations for (b) their quantitative perceptions of the relative importance of a series of clinical\nissues and patient medical conditions as potential topics for creating a PROMPTââ??¢.\nMethods: We applied a mixed methods research design that involved collecting, analyzing, and ââ?¬Å?mixingââ?¬Â both qualitative\nand quantitative methods and data in a single study to answer a research question. Survey One was qualitative in nature\nand asked the study participants to list as free text up to 12 patient medical conditions or clinical issues that they\nperceived to be high priority topics for development of a PROMPTââ??¢. Survey Two was quantitative in nature and\nasked the study participants to rate each of these 57 specific, pre-selected clinical issues and patient medical\nconditions on an 11-point Likert scale of perceived importance as a potential topic for a PROMPTââ??¢. The two electronic,\nonline surveys were completed by participants who were recruited from the faculty in our Department of Anesthesiology\nand Perioperative Medicine and Department of Surgery, and the cohort of hospital-employed certified registered nurse\nanesthetists.\nResults: A total of 57 possible topics for a PROMPTââ??¢ was created and prioritized by our stakeholders. A strong correlation\n(r = 0.82, 95 % CI: 0.71, 0.89, P < 0.001) was observed between the quantitative clinician survey rating scores reported by\nthe anesthesiologists/certified registered nurse anesthetists versus the surgeons. The quantitative survey displayed strong\ninter-rater reliability (ICC = 0.92, P < 0.001).\nConclusions: Our qualitative clinician stakeholder survey generated a comprehensive roster of clinical issues and patient\nmedical conditions. Our subsequent quantitative clinician stakeholder survey indicated that there is generally\nstrong agreement among anesthesiologists/certified registered nurse anesthetists and surgeons about the relative\nimportance of these clinical issues and patient medical conditions as potential topics for perioperative optimization\nand risk management.
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