Login to Access Video or Poster Abstract: MP96-13
Sources of Funding: none

Introduction

Consultant Outcome Publication (COP) regarding outcomes of operations performed by individual surgeons was introduced to UK Urology in 2012 and was championed as a policy to increase transparency of surgical outcomes for patients. Research assessing patient opinion on the introduction of the mandatory health policy is restricted to experience of COP from cardiothoracic surgery in both the US and UK with no research to date from the field of urology. _x000D_ We interviewed patients awaiting surgery to assess if patients are using COP and to evaluate opinion towards the health policy._x000D_

Methods

Patient use of and opinions towards COP were explored through one-on-one concept elicitation interviews. Patients awaiting nephrectomy (radical or partial) were invited to take part in the study following explanation of their diagnosis. Interviews were carried out until thematic saturation was reached (n=15).

Results

Six key topics were identified by the analysis of interview transcripts: _x000D_ (i) Patients are not aware that consultant surgical outcomes are accessible. _x000D_ (ii) Patients welcome a policy to help ensure surgical quality but some voice concern that published data may not be accurate and could lead to risk averse behavior._x000D_ (iii) Investigating the performance of their surgeon is a low priority for patients compared to other stresses at the time of diagnosis including likely presence of cancer, concern for future risk of chronic kidney disease and any problems surgery may cause for their families._x000D_ (iv) Patients regard their own interaction with their surgeon as the most important factor for establishing confidence in their surgeon. _x000D_ (v) Patients take significant reassurance from being referred to a tertiary level service._x000D_ (vi) Patients may base decisions regarding surgery on their own previous experiences of healthcare and also those of family and friends._x000D_

Conclusions

For reassurance prior to surgery patients rely primarily on confidence and trust in their surgeon which are gained from the one-on-one interaction and may only use COP to validate their initial impressions of their surgeon. Our data suggests that although COP was in part introduced to increase transparency of surgical outcomes for patients, patients themselves are not aware that the data is available. Furthermore, even after being informed of COP, patients were still reluctant to access the published data suggesting that the type of information currently being published may not be what patients want, and requires review.

Funding

none