From data to quality: the story of A-QUA, Switzerland's Anaesthesia QUAlity initiative and database.

BACKGROUND: The Swiss Anaesthesia QUAlity (A-QUA) programme, launched by the Swiss Society for Anaesthesiology and Peri-operative Medicine (SSAPM), is a nationwide quality initiative, monitoring anaesthesia processes, events and outcomes.To describe the structure, participation, and data quality of the programme A-QUA, particularly the part 2 registry (case-related anaesthesia data), and illustrate its analytical potential using descriptive statistics and procedure case studies. DESIGN: Observational, retrospective analysis of routine data from 2017 to 2024. SETTING: Public and private Swiss anaesthesia providers, including all SSAPM-accredited teaching and nonteaching hospitals. PATIENTS: All patients receiving anaesthesia from participating providers. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Hospital and clinic participation, case volume, data completeness, results of plausibility checks, patient characteristics, anaesthesia techniques, durations, peri-operative events and postoperative care. RESULTS: By the end of 2024, the A-QUA part 2 registry contained 2 045 026 cases from 54 centres in all Swiss language regions (61% German, 35% French, 4% Italian speaking). Most originated from large teaching hospitals (74%), with smaller contributions from small and medium-sized teaching (17%) and nonteaching (8.8%) hospitals. Median age was 56 years; 52% were women; 66% ASA l to ll. General anaesthesia (including combined) accounted for 74% of cases, regional anaesthesia alone for 18%, and monitored anaesthesia care for 8.5%. Median anaesthesia and surgical durations were 122 and 53 min, respectively. Plausibility checks identified recurrent preventable errors. Case studies of the five most frequent procedures revealed regional and hospital variation in anaesthesia choice, timing, and postoperative destination. CONCLUSIONS: A-QUA is a robust, validated programme for national anaesthesia quality monitoring in Switzerland, enabling benchmarking, targeted quality improvement and peri-operative research through continuous, standardised data collection.