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Home » Research Projects » Managing Medical Performance: A Pilot Study to Investigate the Impact of Surgical Performance Upon Clinicians and Managers

Open heart surgery?

What happens when the mortality rates of cardiac surgeons are made public?

Does transparent reporting of performance data improve the performance of public service professionals? Public reporting of hospital death rates has been adopted in several states and countries in recent years, and within the UK mortality rates of surgeons in Scotland have been publicly reported since 2005 and the mortality rates of hospital units in England from 2008. When the Society of Cardiothoracic Surgeons began publishing mortality rates of cardiac surgeons in England on the internet in 2006, it presented an ideal opportunity to explore the difference transparent reporting makes to performance. Though introduced as a measure to improve performance, some people predicted it would have the opposite effect, with surgeons eschewing clinically difficult cases to make the numbers look better. Surgeons themselves long resisted disclosure of mortality rates on those grounds until newspapers in Scotland and England lodged freedom of information requests for the data to be published.

This project will explore two years of experience of publication of the mortality rates of cardiac surgeons in England, looking at published evidence of performance and exploring the attitudes and perspectives of various players in the medical world to transparent performance reporting.

What the research means to policy-makers and the wider community?

Research Methods

This is an in depth qualitative study based primarily in the cardio-thoracic unit of a single hospital – St George’s Hospital Trust in London. The research team will use a variety of methods to uncover how clinical performance is managed at all levels of the delivery chain. The research comprises:

This will enable the researchers to build up a detailed picture of the attitudes and practices of different stakeholders to performance management. They will be able to identify areas of consensus and difference and highlight the consequences, including those that are unintended, of differing clinical and managerial strategies to performance management.

Project Outputs

Project Poster 2009

Research Team

Mark Exworthy

Mark Exworthy

Mark is Reader in Public Management and Policy at Royal Holloway and is also a member of the Knowledge Network (measurement and evidence) which forms part of the World Health Organisation’s (WHO) Commission on Social Determinants of Health. His research interests are in public management and policy, including primary health care and policies to tackle health inequalities

Tel: +44 01784 414186
Email: M.Exworthy@rhul.ac.uk

Jon Gabe

Jon Gabe

Jon is Professor of Sociology at Royal Holloway and is primarily interested in mental health, health care organisation and chronic illness. He is particularly well known for research on social aspects of tranquilliser use, risk and health and the status of medicine and the medical profession in contemporary society.

Tel: +44 1784 443144
Fax: +44 1784 439 248
E-Mail: J.Gabe@rhul.ac.uk

Glenn Smith

Glenn Smith

Glenn is a Senior Research Fellow specialising in qualitative methods – particularly the use of oral history – to explore issues related to health, medicine and identity. His research has explored the long term experience of disability, the experiences of people who underwent and also administered aversion therapy, the relationship between naturism, sexuality and sexual wellbeing and understanding the relationship between ethnic identity and organ donation. Glenn also advises on several other health related studies at University College London, Imperial College and City University. He is also a member of the social and cultural group of the government taskforce on organ donation.

Email: glenn.smith@rhul.ac.uk

Ian Rees Jones

Ian Rees Jones

Ian is Professor of Sociology of Health at Bangor University. His research interests span the historical sociology of health, medicine and welfare. He is currently working on social theory applied to comparative welfare, social change and inequalities in health, contemporary trends in lifestyle and consumption and ageing and later life in post-war Britain.

Tel: +44 (0) 1248 382232
Fax: +44 (0) 1248 382085
Email: i.r.jones@bangor.ac.uk