British journal of anaesthesia
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Achieving good health outcomes for patients is the fundamental purpose of healthcare. What really matters to patients is the outcome of an intervention and the effect it will have on their wellbeing and life expectancy. After media coverage, and public enquiry into high mortality rates for paediatric cardiac surgery at the Bristol Royal Infirmary during the early 1990s, mortality rates for paediatric cardiac surgical procedures decreased dramatically both in Bristol and nationally. ⋯ There are issues around clinical coding, risk adjustment, the influence of clinical teamworking, and environmental factors. The National Institute of Academic Anaesthesia (NIAA) has identified that the description of clinical practice in anaesthesia and perioperative medicine is currently limited by a lack of valid, reliable quality measures. The NIAA suggests that there is a requirement for further research into identifying the anaesthetic outcome indicators which are most relevant to patients, and then benchmarking the performance of anaesthetic departments and anaesthetists.