Fifty-three out of 100 reviews identified concerns about the quality of surgical outcomes data that is available.
Those requesting reviews often lack accurate and universally-agreed information about the outcomes of the individual surgeons they employ, or the services they provide.
Common themes are:
- Absence of data on surgical complications such as leak rates and readmission rates, resection margins, length of stays and other indicators of clinical quality.
- Variable quality of data – some surgeons provide detailed information about activity and outcomes while others are unable to submit figures.
- Datasets are inconsistent, due to the methodology used or the accuracy with which the data was collected and presented.
- Variable submission of outcomes data to national databases.
- Inaccurate or incorrect coding of clinical procedures due to poor quality outcomes data collection or lack of capacity.
An inferior level of information means that hospitals cannot provide immediate reassurance if a problem occurs. Moreover, standards of patient care can be overlooked while debate takes place about the quality of data.
It can be concluded that hospitals and their surgeons must prioritise collation of high-quality outcome data. Maintaining good quality information about activity, outcomes and rates of complication is a very clear indicator of effective management and leadership of a surgical service as well as the quality of surgical care.