Ben Bridgewater, Director of Clinical Audit, University Hospital of South Manchester NHS Foundation Trust, discusses how to measure outcomes for surgery, including the patient's perspective.

1. Reducing unwarranted variations in health care Measuring outcomes for surgery: Including patient experience The King’s Fund 14 September 2011 Ben Bridgewater UHSM and Manchester Academic Health Science Centre

2. Clinical outcomes in cardiac surgery Detecting variance Improving quality Utilising patient experience

6. UK database >400,000 operation records patient characteristics operative details post-operative outcomes mortality complications long-term mortality www.scts.org dendrite clinical systems ltd

7. BMJ 2005;330:506-510 (5 March) Mortality data in adult cardiac surgery for named surgeons: retrospective examination of prospectively collected data on coronary artery surgery and aortic valve replacement Ben Bridgewater, consultant surgeon1 on behalf of the adult cardiac surgeons of north west England

10. Public reporting Since 2005 All NHS hospitals mandatory >70% surgeons voluntary Professional society in conjunction with organisational regulator 26,000 hits per month

13. Benefits?

16. CQC GMC Royal colleges NCAS trusts individual

17. Managing divergent performance

18. Organisation quality improvement

20. Individual quality improvement

21. Individual quality improvement

23. Domains of quality Clinical outcomes Patient safety Patient experience

27. Findings Range

29. Summary Collecting and publishing clinical outcomes data drives quality Cardiac surgery has shown it is possible with complete coverage consider adverse negative consequences Need to consider wider domains of quality from patient perspective Robust methodologies are being developed Professional revalidation should drive engagement