title: A change in opinion on surgeon's performance indicators.
abstract: Individual performance indicators for cardiac surgeons in the UK were published in 2004. A comprehensive update published in 2009 reported statistically significant decreases in mortality rates suggesting that the publication of this data may have contributed to this improvement in outcomes. In view of this, the authors present an assessment of the attitudes of cardiac surgeons to individual performance tables, having performed this by sending questionnaires exploring the surgeon's views on performance tables to UK cardiac surgeons in 2005 and 2009. The responses demonstrated that whilst the majority of cardiac surgeons (68.8%) were initially opposed to performance tables, the number welcoming their introduction increased significantly (22.9-48.5%) over the four-year period. The attitude of the consultants towards the possible effect of this data on the management of high-risk patients also changed, with fewer consultants believing they would (P=0.0001) or may (P=0.023) avoid these patients. The observed change in attitude of cardiac surgeons may be due to acclimatization to an established system of audit, improved mortality rates, a desire for more transparency following the Bristol Enquiry, or improved risk stratification. These findings may be of benefit to those tasked with initiating these indicators elsewhere.
authors.affiliation: Renal Transplant Unit, St George's Hospital NHS Trust, Blackshaw Road, Tooting, London SW17 0QT, UK. gdmaytham@mac.com
authors.forename: Gary
authors.initials: G
authors.lastname: Maytham
authors.forename: Nicos
authors.initials: N
authors.lastname: Kessaris
mesh_terms: D001291:Attitude of Health Personnel; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D016009:Chi-Square Distribution; D002983:Clinical Competence / Q000592:standards*; D003253:Consultants; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D018579:Patient Selection; D010465:Perception; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011639:Public Opinion; D019984:Quality Indicators, Health Care / Q000592:standards*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014342:Truth Disclosure; D006113:United Kingdom