Reporting performance information

Surgeon performance information has been collected, tabulated and publicly reported since the early 1990s, first in New York State and then in other American States, and now in the United Kingdom. Performance information on surgical units and on hospitals has been collected for some time before this, but the public release of such information is a relatively recent phenomenon, as are report cards on the performance of individual surgeons and certain other clinicians. In this final section of the collection we turn our attention to the ‘report cards movement’ itself, with chapters examining a variety of issues that have emerged in studies of the impact of report cards on the performance of hospitals, units and individual surgeons.

Our first chapter in the section, by Silvana Marasco and Joseph Ibrahim, examines the impact of public reporting of surgeons' performance on patient care. The authors consider, in some detail, the impact of cardiac surgeon report cards on the quality of cardiac surgery, on cardiac patients and on cardiac surgeons and other stakeholders, particularly in light of the US experience with report cards on individual cardiac surgeons. Rachel Werner and David Asch also examine evidence of the impact of public reporting on the quality of health care services. They argue that existing US public reporting initiatives have not been conclusively shown to improve healthcare quality, and indeed, that there is some evidence that public reporting has various unintended negative consequences for patient care.