Intended for healthcare professionals

Rapid response to:


Measuring hospital clinical outcomes

BMJ 2013; 346 doi: (Published 30 January 2013) Cite this as: BMJ 2013;346:f620

Rapid Response:

Re: Measuring hospital clinical outcomes

Sadly, the reader drawn in anticipation to the title of this article will not find any practical help within. The dry commentary on the difficulties of capturing meaningful clinical information is nihilistic in the extreme.

In their one thread of optimism, the authors look forward to the fact that "the science of healthcare measurement is advancing rapidly". Yet what fancy science did Joseph Lister need to establish that the use of an antiseptic spray reduced post-operative wound infections? He counted them.

The fact is that we already have all the tools to measure basic indicators of outcomes for many major interventions or treatments. Indeed our hospitals are awash with paper spewing out meaningless graphs, pie charts and statistics, sadly mostly about financial matters and which do not generally command the confidence of clinicans. Our problem is that we are not asking the right questions of the apparatus which presently exists. For example, a very simple start would be to create, by concensus, a list of the 6 most important outcome indicators for the 20 commonest procedures in a health setting and record these religiously for several years. Meaningful patterns would quickly emerge. In Krumholz's article, the only single parameter mentioned is death. We can do much better with little more expense and no requirement for 'advances in the science of healthcare measurement'!

Competing interests: No competing interests

01 February 2013
Peter J Mahaffey
Bedford Hospital NHS Trust
Kempston Rd Bedford MK42 9DJ