Start and end dates

October 2012-October 2015


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Project summary


This project involves two key elements:

  • Studying the measurement of performance within surgery.
  • Developing a methodology for the assessment of individual surgical units to discern key features that may be associated with performance status.

Within healthcare, the definition of quality may encompass a broad range of criteria including effectiveness, efficiency and safety, amongst others. Therefore, a single outcome measure cannot reflect overall system performance. Using various administrative and/or clinical databases, the relationship between measures of institutional performance will be explored.

Outcome measures may enable identification of variation in the results achieved by different surgical units, but cannot by themselves be used to instruct quality improvement activity. A method of assessing surgical units will be developed, with the goal of understanding organisational differences that may be associated with good or poor performance.

It is intended that the results of this work will then be disseminated to the units studied and other healthcare organisations to help guide future improvements in surgical services.


  • To understand how the best surgical units consistently achieve their results


Peer-Reviewed Publications

  • Byrne BE, Pinto A, Aylin P, Bottle A, Faiz OD, Vincent CA. Understanding how colorectal units achieve short length of stay: an interview survey among representative hospitals in England. Patient Saf Surg. 2015 Jan; 23;9(1):2. PubMed
  • Byrne BE, Mamidanna R, Vincent CA, Faiz O. Outlier identification in colorectal surgery should separate elective and nonelective service components. Dis Colon Rectum. 2014 Sep; 57(9):1098-104. PubMed
  • Byrne BE, Mamidanna R, Vincent CA, Faiz O. Population-based cohort study comparing 30- and 90-day institutional mortality rates after colorectal surgery.Br J Surg. 2013 Dec;100(13):1810-7. PubMed

Conference Presentations

  • B E Byrne, P Aylin, R A Bottle, O D Faiz, A Darzi, C A Vincent. Failure to engage in surgical quality improvement research is associated with poorer quality of care.  Royal Society of Medicine, Coloproctology section: Overseas meeting in Leuven, Belgium. May 2015.
  • Byrne B, Mamidanna R, Vincent CA, et al. 2014, Variation in outcomes between elective and non-elective colorectal surgery: a population-based cohort study., Digestive Diseases Week.
  • Byrne BE, Mamidanna R, Vincent CA, et al. 2013, Variation in outcomes between elective and non-elective colorectal surgery: a population-based cohort study., Royal Society of Medicine, Coloproctology Section: John of Arderne medal short papers session.
  • B E Byrne, R Mamidanna, C A Vincent, O Faiz.Examining the impact of using 90-day rather than 30-day mortality rates for identifying poor performing surgical providers in colorectal surgery: a population-based cohort study. European Society of Coloproctology meeting, Belgrade, September 2013.