UK Trainee Cardiothoracic Surgeons' Perceptions of Public Outcome Reporting in Surgery: A Mixed-Methods Study.

Background Since 2004, the Society for Cardiothoracic Surgery in Great Britain and Ireland has reported outcomes of named surgeons. In 2013, the National Health Service England published outcome data for 10 specialties, including cardiothoracic surgery. Before this, no consistent and major stakeholder feedback had occurred. This is the first study to assess UK trainee cardiothoracic surgeons' perceptions of public outcome reporting (POR) in surgery. Methodology In this study, first, an online survey was sent to all trainee cardiothoracic surgeons (n = 257) in the UK. The survey had a response rate of 17%. Second, 10 semi-structured, one-to-one interviews were conducted with trainee cardiothoracic surgeons who had completed the survey. Results The majority of respondents opposed the public release of surgeon-specific mortality data in adult cardiac surgery. It is believed to be associated with several consequences, including risk aversion, 'gaming', and detriments to the training and development of surgeons. Despite this, the majority of respondents favoured the POR of alternative outcome measures, including unit mortality, which provides a better indicator for the overall quality of care provided to patients. Conclusions Trainee cardiothoracic surgeons accept and approve of POR. However, policymakers should refine the current strategy if they are to receive full support from the future of the specialty.