Editor's Choice

Mid Staffs and mortality data

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f638 (Published 30 January 2013) Cite this as: BMJ 2013;346:f638

Re: Mid Staffs and mortality data

The validity and reliability of performance data must of course be continuously examined and interrogated if we are to have confidence in subsequent analysis, recommendations and actions.
But as Fiona Godlee indicates, performance data are developed and interpreted within and by a particular culture of presuppositions, opinions and motivations: An identical set of data can trigger a myriad of responses that might or might not support quality and patient safety. For example, can a top leadership team withstand the pressure to implement short 'work-arounds' that 'fix' the metrics in favour of longer-term solutions that work at the attitudes and values level?
A mixed-methods and multidisciplinary approach to conceptualising, measuring and addressing quality which incorporates 'flagging' quantitative data and 'meaning' qualitative data may well help us to step back and get off the carousel of failure-metrics-short term fixes - more failure.

Competing interests: No competing interests
02 February 2013
Jagdeesh Singh Dhaliwal
GP/Leadership and Management Academic
Keele Medical School
Birmingham
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