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Invited Commentary
February 2014

Hospital Report Cards: Necessary but Not Sufficient?

Author Affiliations
  • 1Department of Surgery, University of Michigan, Ann Arbor
JAMA Surg. 2014;149(2):143-144. doi:10.1001/jamasurg.2013.3996

Performance feedback is increasingly used as a strategy to motivate surgeons to improve. Numerous surgical specialties have launched clinical registries to generate reports of risk-adjusted outcomes including cardiac, bariatric, general, vascular, and trauma surgical procedures. These reports are fed back to hospitals, allowing them to identify problem areas such as higher-than-expected complication rates. In theory, hospitals then implement changes to address these shortcomings. Proponents of performance feedback argue that hospitals and surgeons, once they know where they do not measure up, will make the necessary changes to improve outcomes. However, many believe that this view is too optimistic; that is, that feedback alone is not enough to spur improvement. In this issue of JAMA Surgery, Glance et al1 provide strong evidence supporting the latter.

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