Postoperative Quality of Recovery (QoR-15)
15-item tool to measure the early postoperative health status of patients after anesthesia.
Provided by
EVAL FoundationThe Postoperative Quality of Recovery Scale (QoR-15) is a validated, patient-reported outcome measure (PROM) designed to assess how well a person is recovering in the first 24 to 48 hours after surgery and anesthesia. Unlike traditional medical metrics that focus on "negative" outcomes (like infection or death), the QoR-15 focuses on the patient’s perspective of their well-being across five distinct areas of health.
How the Tool Works
The scale consists of 15 simple questions that a patient answers by picking a number from 0 to 10. It is intentionally brief, taking most patients less than 3 minutes to complete.
1. The Five Dimensions of Recovery
The tool doesn't just ask about pain; it captures a holistic view of the patient's state through:
- Pain: Severity of moderate and severe pain.
- Physical Comfort: Issues like nausea, vomiting, and quality of sleep.
- Physical Independence: Ability to wash, dress, and look after oneself.
- Psychological Support: Feeling supported by hospital staff and family.
- Emotional State: Levels of anxiety, depression, and general "well-being."
2. The Scoring Logic
- Wellness Items (10 Questions): For things like "feeling rested" or "breathing easily," a 10 is the best possible score.
- Symptom Items (5 Questions): For "bad" things like "nausea" or "pain," the score is reversed. A patient’s reported 10 (high pain) becomes a 0 for the final score, while a reported 0 (no pain) becomes a 10.
- Final Result: All points are added up for a total between 0 and 150.
Why It Is Used
The QoR-15 is considered the "gold standard" in perioperative research because it is:
- Valid & Reliable: It consistently measures what it’s supposed to and gives similar results if a patient’s condition hasn’t changed.
- Sensitive to Change: It can detect even small improvements or declines in a patient’s condition (the "6-point rule").
- Predictive: Patients who score below 90 are statistically more likely to have complications later in their recovery or require readmission to the hospital.
Summary of Interpretation
| Score | Meaning | Action Level |
|---|---|---|
| 136–150 | Excellent | Routine care; preparing for discharge. |
| 122–135 | Good | Expected recovery trajectory. |
| 90–121 | Moderate | Potential issues; monitor closely. |
| < 90 | Poor | Red Flag: High risk; requires clinical intervention. |
Additional alerts will appear.
| Result | Description |
| Breathing Difficulty < 5 pts | Immediately contact your medical team or seek emergency care. Report any new or concerning symptoms to your medical team. |
| Severe Pain < 3pts | Immediately contact your medical team or seek emergency care. Report any new or concerning symptoms to your medical team. |
| Moderate Pain < 3pts | Immediately contact your medical team or seek emergency care. Report any new or concerning symptoms to your medical team. |
| Psychological Distress - "Feeling worried/anxious" < 3 pts AND "Feeling sad/depressed" < 3 pts | Immediately contact your medical team or seek emergency care. Report any new or concerning symptoms to your medical team. Your doctor may screen you for cognitive decline or significant psychological stress and may offer consultation for social work or spiritual care. |
| Nausea / Vomiting < 5 | Immediately contact your medical team or seek emergency care. Report any new or concerning symptoms to your medical team. |
| Well-being OR Control < 3 pts | Immediately contact your medical team or seek emergency care. Report any new or concerning symptoms to your medical team. Your doctor may screen you for cognitive decline or significant psychological stress and may offer consultation for social work or spiritual care.
|
| Physical Independence < 3 pts | Contact your medical team. Report any new or concerning symptoms to your medical team. |
| Medical Support < 5 pts | Contact your medical team. Report any new or concerning symptoms to your medical team. |
| Food Intake < 2 pts | Immediately contact your medical team or seek emergency care. Report any new or concerning symptoms to your medical team. |
| Anxiety < 3 pts | Feelings of overwhelm can be normal after surgery. However, it is important to contact your healthcare team and consider further evaluation. Your doctor may screen you for cognitive decline or significant psychological stress and may offer consultation for social work or spiritual care. |
| Sadness < 3 pts | Feelings of overwhelm can be normal after surgery. However, it is important to contact your healthcare team and consider further evaluation. Your doctor may screen you for cognitive decline or significant psychological stress and may offer consultation for social work or spiritual care.
|
Note: You have the option to override the alert tags of the results in your account's admin feature. Additionally, you have the option to clone this tool and modify it to your clinic specifications.
All questions & possible results
Surgical StatusTitle not visible
My surgical status is
Select one option:
- Preoperative (before surgery)
- Postoperative (after surgery)
When was your surgery?
A date.
Part A: Instructions
How have you been feeling in the last 24 hours?
- Enter a number from 0 to 10, where:
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
1. Able to breathe easily
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
2. Been able to enjoy food
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
3. Feeling rested
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
4. Have had a good sleep
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
5. Able to look after personal toilet and hygiene unaided
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
6. Able to communicated with family or friends
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
7. Getting support from hospital doctors and nurses
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
8. Able to return to work or usual home activities
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
9. Feeling comfortable and in control
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
10. Having a feeling of general well-being
in the last 24 hours?
- 0 = none of the time [poor]
- 10 = all of the time [excellent]
Select one option:
- 0 - Poor
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10 - Excellent
Part B: Instructions
Have you had any of the following in the last 24 hours?
- Enter a number from 10 to 0, where:
- 10 = none of the time [excellent]
- 0 = all of the time [poor]
11. Moderate pain
in the last 24 hours?
- 10 = none of the time [excellent]
- 0 = all of the time [poor]
Select one option:
- 10 - Excellent
- 9
- 8
- 7
- 6
- 5
- 4
- 3
- 2
- 1
- 0 - Poor
12. Severe pain
in the last 24 hours?
- 10 = none of the time [excellent]
- 0 = all of the time [poor]
Select one option:
- 10 - Excellent
- 9
- 8
- 7
- 6
- 5
- 4
- 3
- 2
- 1
- 0 - Poor
13. Nausea or vomiting
in the last 24 hours?
- 10 = none of the time [excellent]
- 0 = all of the time [poor]
Select one option:
- 10 - Excellent
- 9
- 8
- 7
- 6
- 5
- 4
- 3
- 2
- 1
- 0 - Poor
14. Feeling worried or anxious
in the last 24 hours?
- 10 = none of the time [excellent]
- 0 = all of the time [poor]
Select one option:
- 10 - Excellent
- 9
- 8
- 7
- 6
- 5
- 4
- 3
- 2
- 1
- 0 - Poor
15. Feeling sad or depressed
in the last 24 hours?
- 10 = none of the time [excellent]
- 0 = all of the time [poor]
Select one option:
- 10 - Excellent
- 9
- 8
- 7
- 6
- 5
- 4
- 3
- 2
- 1
- 0 - Poor
Possible results
Food Intake < 2 pts
- Immediately contact your medical team or seek emergency care.
- Report any new or concerning symptoms to your medical team.
Excellent Recovery Score (136-150 pts)
- Continue your postoperative care plan as prescribed by your medical team.
- Report any new or concerning symptoms to your medical team.
Clinical Application:
The MCID (Minimal Clinically Important Difference)
- The MCID is the smallest change in a score that represents a meaningful change in the patient's health.
- The Threshold: 6 to 8 points.
- You should flag any drop of ≥8 points between two consecutive entries. Even if the patient is still in the "Good" range, a 10-point drop in 24 hours is a significant red flag for a new complication.
Anxiety < 3 pts
- Feelings of overwhelm can be normal after surgery.
- However, it is important to contact your healthcare team and consider further evaluation.
- Your doctor may screen you for cognitive decline or significant psychological stress and may offer consultation for social work or spiritual care.
Physical Independence < 3 pts
- Contact your medical team.
- Report any new or concerning symptoms to your medical team.
Nausea / Vomiting < 5
- Immediately contact your medical team or seek emergency care.
- Report any new or concerning symptoms to your medical team.
Sadness < 3 pts
- Feelings of overwhelm can be normal after surgery.
- However, it is important to contact your healthcare team and consider further evaluation.
- Your doctor may screen you for cognitive decline and offer consultation for social work or spiritual care.
Psychological Distress - "Feeling worried/anxious" < 3 pts AND "Feeling sad/depressed" < 3 pts
- Immediately contact your medical team or seek emergency care.
- Report any new or concerning symptoms to your medical team.
- Your doctor may screen you for cognitive decline or significant psychological stress and may offer consultation for social work or spiritual care.
Breathing Difficulty < 5 pts
- Immediately contact your medical team or seek emergency care.
- Report any new or concerning symptoms to your medical team.
Good Recovery Score (122-135 pts)
- Continue your postoperative care plan as prescribed by your medical team.
- Report any new or concerning symptoms to your medical team.
Clinical Application:
The MCID (Minimal Clinically Important Difference)
- The MCID is the smallest change in a score that represents a meaningful change in the patient's health.
- The Threshold: 6 to 8 points.
- You should flag any drop of ≥8 points between two consecutive entries. Even if the patient is still in the "Good" range, a 10-point drop in 24 hours is a significant red flag for a new complication.
Moderate Pain < 3 pts
- Immediately contact your medical team or seek emergency care.
- Report any new or concerning symptoms to your medical team.
Well-being OR Control < 3 pts
- Immediately contact your medical team or seek emergency care.
- Report any new or concerning symptoms to your medical team.
- Your doctor may screen you for cognitive decline or significant psychological stress and may offer consultation for social work or spiritual care.
Medical Support < 5 pts
- Contact your medical team.
- Report any new or concerning symptoms to your medical team.
Poor Recovery Score (0-89 pts)
- Immediately contact your medical team or seek emergency care.
- Report any new or concerning symptoms to your medical team.
Clinical Application:
- Research has shown that a score below 90 on the first day after surgery is strongly associated with an increased risk of complications within the next 30 days.
- The MCID (Minimal Clinically Important Difference)
- The MCID is the smallest change in a score that represents a meaningful change in the patient's health.
- The Threshold: 6 to 8 points.
- You should flag any drop of ≥8 points between two consecutive entries. Even if the patient is still in the "Good" range, a 10-point drop in 24 hours is a significant red flag for a new complication.
Moderate Recovery Score (90-121 pts)
- Continue your postoperative care plan as prescribed by your medical team.
- Promptly report any new or concerning symptoms to your medical team.
Clinical Application:
The MCID (Minimal Clinically Important Difference)
- The MCID is the smallest change in a score that represents a meaningful change in the patient's health.
- The Threshold: 6 to 8 points.
- You should flag any drop of ≥8 points between two consecutive entries. Even if the patient is still in the "Good" range, a 10-point drop in 24 hours is a significant red flag for a new complication.
Severe Pain < 3 pts
- Immediately contact your medical team or seek emergency care.
- Report any new or concerning symptoms to your medical team.
Citation
Stark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology. 2013 Jun;118(6):1332-40. doi: 10.1097/ALN.0b013e318289b84b. PMID: 23411725.
