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Surgical Innovation
January 2016

The Surgeon Cost Report Card: A Novel Cost-Performance Feedback Tool

Author Affiliations
  • 1Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 2Division of General Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
JAMA Surg. 2016;151(1):79-80. doi:10.1001/jamasurg.2015.2666

We developed a novel cost-performance feedback tool to provide surgeons with a continuous assessment of operating room expenditures. This “Surgeon Cost Report Card” is an email message meant to increase surgeons’ awareness of costs and encourage changes in behavior (Figure). A smartphone-compatible design maximizes usability. Cost data are aggregated and subdivided by item categories. Individual and collective averages are presented, promoting comparison with derived group standards by time period and procedure type. Intuitive color-coding is used to direct attention. It also reinforces the goal of cost reduction, taking advantage of the competitive culture intrinsic to surgical practice. Positive feedback is given by naming the best performer in the group, further encouraging healthy peer-to-peer competition. Privacy is protected by customizing the report card for individual surgeons. The report interval can be freely adjusted based on case volume to balance timely feedback with adequate sample size. Automation of the data processing required to generate the report card enables rapid deployment with minimal administrative requirements.