Postoperative Quality of Recovery Scale

Quality of recovery following surgery & anaesthesia is of vital importance to improving patient outcome & clinical practice.

CE Mark

PostopQRS™ is a digital measurement tool, aka an electronic Clinical Outcomes Assessment (eCOA) solution that is CE Marked as a Class 1 Medical Device within the UK and Europe to assess multiple domains of post-operative recovery over time.

1. What is PostopQRS?

The Post-operative Quality of Recovery Scale (PostopQRS) is a digital measurement tool to quantify quality of recovery after surgery and anaesthesia. It is principally comprised of a number of questions that objectively measure patient recovery, which are clustered into five different domains (physiological, emotive, nociceptive, activities of daily living, and cognitive) and one self-assessment domain. It has been designed to measure recovery over multiple time periods. 

2. How is the PostopQRS digital assessment conducted?

The PostopQRS is conducted by utilising some commonly available hospital data and also an investigator asking a series of questions to the patient. These can be conducted face-to-face, or over the telephone. Typically, the baseline (pre-surgery) and in-hospital tests are performed face-to-face, but after hospital discharge, it can be conducted over the telephone.

3. How long does it take to conduct the PostopQRS?

It takes approximately 5 to 6 minutes to conduct the PostopQRS on each occasion.

4. What is meant by the term "recovery"?

Recovery means that the patient has returned to their pre-surgery state, or has improved from that. To quantify this, the post operative value for each test is subtracted from the baseline value, and if the difference is = 0 or negative, then the patient is scored as recovered. The exception to this rule is for the cognitive domain, where we introduce a tolerance factor to account for normal performance variability in cognitive tests. The patients can perform a little bit worse than baseline in the cognitive domain and still be scored as recovered. Recovery is then scored for each domain, and patients must recover in all tests within the domain to be scored as recovered. "All domains" recovery implies recovery in all of the five recovery domains. The self-assessment domain is not strictly a recovery domain as it does not have a baseline value. Rather, this domain is used to identify the patient's subjective opinions about the recovery process, including satisfaction.

5. When to conduct the PostopQRS?

All patients must have a pre-surgery PostopQRS assessment, as it captures the baseline state of the patient. After surgery, the investigator can determine when to measure recovery, according to the type of surgery, type of intervention, and length of follow-up that they wish to evaluate. Typically there are four major time periods of the valuation that will examine different aspects of recovery:

  1. Immediate Recovery: this is conducted within 10 to 30 minutes after the end of anaesthesia delivery. The primary focus is on physiological and nociceptive recovery.
  2. Early Recovery: this is conducted within the first few hours after surgery, and is often performed just prior to discharge from the PACU or on return to the ward. This time point measures physiological recovery as well as early nociceptive and emotive, and cognitive recovery.
  3. Late Recovery: this is conducted in the first week after surgery (there may be several measurements during this period). The focus shifts from physiological recovery to nociceptive, emotive, cognitive, and functional (activities of daily living) recovery, as well as documenting patient self-assessment including satisfaction.
  4. Long Term Recovery: this is typically conducted months after surgery and examines long-term recovery in all domains other than physiological.
  5. Additional time points: this is at the discretion of the investigator.

6. How do I analyse the data?

You will be able to export your data into a format that can be analysed using conventional statistical packages. Information on scoring recovery data is available on the members homepage. PostopQRS Ltd offers an additional advisory service on data analysis if required.

7. Free Training Available

You can access free training and reference materials via the member’s portal. All tutorials are on the member's User home page.

8. How to access PostopQRS?

The PostopQRS tool was initially available without cost. This facility has now ended and the tool is now a paid for service. In order to access the tool, you need to sign up as a registered User, accept the terms and conditions and complete the questions which will determine the fee. These fees vary according to use. The tool is not to be modified by the User but you are free to vary the times and frequency that it is used.  

Wherever possible we seek your permission for us to analyse your anonymous data. This will allow us to produce benchmark data for different treatments. It will also provide an additional service, as you will be able to compare how your centre/technique compares with national or international data.

9. Can I collect additional data?

Once you sign-up to PostopQRS-online, you will have access to a primary dataset including patient demographics and surgical and anaesthetic details. You can also add your own specific questions. If you choose to add questions, then you would need to record that separately in your own spreadsheet or database, and simply use the PostopQRS website to enter data for the PostopQRS tool.

10. How do I get started?

In order to get access to the PostopQRS materials, you will need to sign up as a User and accept the terms and conditions of use. You will then have access to entering the data, as well as to the training package. It is important, that all Users of the PostopQRS read through and become familiar with the training package. This is designed to improve consistency of use with the tool. In the training package, there is a step-by-step guide on how to enter the data. Resources such as the "Faces Chart" can be downloaded and printed by Users to give to patients.

11. Can others working with me to get access to the PostopQRS?

The data entry is designed for either an individual User, or a group of Users wherever their geographic location. When you set up your user profile, you will be able to assign other members working with you to use the tool. This will allow you and those you wish to work with you to access your data entry as well as analysis.

12. Can anyone else see our data?

Users are restricted to seeing their own data only. We are developing benchmark data for different procedures. All data output will be de-identified, other than the country of origin. All data entry to the PostopQRS must be de-identified at the point of data entry. This provides privacy protection to patients and satisfies data protection procedures. You will need to keep any re-identifying records securely within your own database or filing system.

13. If I need help with the PostopQRS, whom do I ask?

Basic information regarding your data can often be sourced from your local institution. However, if you have questions specifically related to the PostopQRS, please send us an email through the Contact us tab. This will be forwarded to one of the members of the PostopQRS Ltd team who will contact you to discuss your query.