Disclosing clinical performance: the case of cardiac surgery. / Smith, G.; I.R. , Jones; Gabe, Jonathan.

In: Journal of Health, Organization and Management, Vol. 24, No. 6, 2010, p. 571-583.

Research output: Contribution to journalArticle

Published

Standard

Disclosing clinical performance: the case of cardiac surgery. / Smith, G.; I.R. , Jones; Gabe, Jonathan.

In: Journal of Health, Organization and Management, Vol. 24, No. 6, 2010, p. 571-583.

Research output: Contribution to journalArticle

Harvard

Smith, G, I.R. , J & Gabe, J 2010, 'Disclosing clinical performance: the case of cardiac surgery', Journal of Health, Organization and Management, vol. 24, no. 6, pp. 571-583. https://doi.org/10.1108/14777261011088665

APA

Smith, G., I.R. , J., & Gabe, J. (2010). Disclosing clinical performance: the case of cardiac surgery. Journal of Health, Organization and Management, 24(6), 571-583. https://doi.org/10.1108/14777261011088665

Vancouver

Smith G, I.R. J, Gabe J. Disclosing clinical performance: the case of cardiac surgery. Journal of Health, Organization and Management. 2010;24(6):571-583. https://doi.org/10.1108/14777261011088665

Author

Smith, G. ; I.R. , Jones ; Gabe, Jonathan. / Disclosing clinical performance: the case of cardiac surgery. In: Journal of Health, Organization and Management. 2010 ; Vol. 24, No. 6. pp. 571-583.

BibTeX

@article{90287ec8e8d24aa0873bb2e6e8980de3,
title = "Disclosing clinical performance: the case of cardiac surgery",
abstract = "PURPOSE: In recent years, the clinical performance of named cardiac surgeons in England has been disclosed. This paper aims to explore the nature and impact of disclosure of clinical performance.DESIGN/METHODOLOGY/APPROACH: The paper draws on literature from across the social sciences to assess the impact of disclosure, as a form of transparency, in improving clinical performance. Specifically, it employs the {"}programme theory{"} of disclosure.FINDINGS: The {"}programme theory{"} of disclosure involves identification, naming, public sanction and recipient response. Named individual (consultant) surgeons have been identified through disclosure but this masks the contribution of the clinical team, including junior surgeons. Mortality is the prime performance measure but given low mortality rates, there are problems interpreting this measure. The naming of surgeons has been achieved through disclosure on web sites, developed between the health-care regulator and the surgical profession itself. However, participation remains voluntary. The intention of disclosure is that interested parties (especially patients) will shun poorly performing surgeons. However, these parties' willingness and ability to exercise this sanction appears limited. Surgeons' responses are emergent but about a quarter of surgeons are not participating currently. Fears that surgeons would avoid high-risk patients seem to have been unrealised. While disclosure may have a small effect on individual reputations, the surgical profession as a whole has embraced disclosure. ORIGINALITY/VALUE: While the aim of disclosure has been to create a transparent medical system and to improve clinical performance, disclosure may have the opposite effect, concealing some performance issues and possibly strengthening professional autonomy. Disclosure therefore represents greater transparency in health-care but it is uncertain whether it will improve performance in the ways that the policy intends.",
author = "G. Smith and Jones I.R. and Jonathan Gabe",
year = "2010",
doi = "10.1108/14777261011088665",
language = "English",
volume = "24",
pages = "571--583",
journal = "Journal of Health, Organization and Management",
issn = "1477-7266",
publisher = "Emerald Group Publishing Ltd.",
number = "6",

}

RIS

TY - JOUR

T1 - Disclosing clinical performance: the case of cardiac surgery

AU - Smith, G.

AU - I.R. , Jones

AU - Gabe, Jonathan

PY - 2010

Y1 - 2010

N2 - PURPOSE: In recent years, the clinical performance of named cardiac surgeons in England has been disclosed. This paper aims to explore the nature and impact of disclosure of clinical performance.DESIGN/METHODOLOGY/APPROACH: The paper draws on literature from across the social sciences to assess the impact of disclosure, as a form of transparency, in improving clinical performance. Specifically, it employs the "programme theory" of disclosure.FINDINGS: The "programme theory" of disclosure involves identification, naming, public sanction and recipient response. Named individual (consultant) surgeons have been identified through disclosure but this masks the contribution of the clinical team, including junior surgeons. Mortality is the prime performance measure but given low mortality rates, there are problems interpreting this measure. The naming of surgeons has been achieved through disclosure on web sites, developed between the health-care regulator and the surgical profession itself. However, participation remains voluntary. The intention of disclosure is that interested parties (especially patients) will shun poorly performing surgeons. However, these parties' willingness and ability to exercise this sanction appears limited. Surgeons' responses are emergent but about a quarter of surgeons are not participating currently. Fears that surgeons would avoid high-risk patients seem to have been unrealised. While disclosure may have a small effect on individual reputations, the surgical profession as a whole has embraced disclosure. ORIGINALITY/VALUE: While the aim of disclosure has been to create a transparent medical system and to improve clinical performance, disclosure may have the opposite effect, concealing some performance issues and possibly strengthening professional autonomy. Disclosure therefore represents greater transparency in health-care but it is uncertain whether it will improve performance in the ways that the policy intends.

AB - PURPOSE: In recent years, the clinical performance of named cardiac surgeons in England has been disclosed. This paper aims to explore the nature and impact of disclosure of clinical performance.DESIGN/METHODOLOGY/APPROACH: The paper draws on literature from across the social sciences to assess the impact of disclosure, as a form of transparency, in improving clinical performance. Specifically, it employs the "programme theory" of disclosure.FINDINGS: The "programme theory" of disclosure involves identification, naming, public sanction and recipient response. Named individual (consultant) surgeons have been identified through disclosure but this masks the contribution of the clinical team, including junior surgeons. Mortality is the prime performance measure but given low mortality rates, there are problems interpreting this measure. The naming of surgeons has been achieved through disclosure on web sites, developed between the health-care regulator and the surgical profession itself. However, participation remains voluntary. The intention of disclosure is that interested parties (especially patients) will shun poorly performing surgeons. However, these parties' willingness and ability to exercise this sanction appears limited. Surgeons' responses are emergent but about a quarter of surgeons are not participating currently. Fears that surgeons would avoid high-risk patients seem to have been unrealised. While disclosure may have a small effect on individual reputations, the surgical profession as a whole has embraced disclosure. ORIGINALITY/VALUE: While the aim of disclosure has been to create a transparent medical system and to improve clinical performance, disclosure may have the opposite effect, concealing some performance issues and possibly strengthening professional autonomy. Disclosure therefore represents greater transparency in health-care but it is uncertain whether it will improve performance in the ways that the policy intends.

U2 - 10.1108/14777261011088665

DO - 10.1108/14777261011088665

M3 - Article

VL - 24

SP - 571

EP - 583

JO - Journal of Health, Organization and Management

JF - Journal of Health, Organization and Management

SN - 1477-7266

IS - 6

ER -