Great Ormond Street Hospital (GOSH) always aims to provide the best possible care. To help us monitor the quality of our services, we measure what we do and how we do it.
Measuring clinical outcomes
We all want to improve our healthcare. All aspects of this, from the improved health of an individual to improved hospital experience, can be measured. Clinical outcomes are broadly agreed, measurable changes in health or quality of life that result from our care. Constant review of our clinical outcomes establishes standards against which to continuously improve all aspects of our practice.
Clinical outcomes can be measured by activity data such as hospital re-admission rates, or by agreed scales and other forms of measurement. They can be recorded by administrators or by clinical staff such as doctors, nurses, psychologists or allied health professionals (e.g. physiotherapists, dietitians).
The navigation bar to the left lists the specialties with published outcomes available. Click on the specialty of interest to view the outcomes. These pages have been designed with input from parents and patients, to ensure that the content is accessible to our families as well as to commissioners and other health professionals.
Patient-reported outcome measures
Outcome measures can also be reported by patients and their families. Measures of treatment outcomes from the patient's perspective are called patient-reported outcome measures (PROMs). PROMs are an important part of outcomes measurement because they provide a patient-led assessment of health, and health-related quality of life.
In October 2011, we undertook expert service user consultations with a small group of patients attending GOSH services and their family members as a first step to exploring patient and parent views of PROMs and patient-reported experience measures (PREMs).
These consultations subsequently informed a multi-professional workshop on PROMs and PREMs in paediatric healthcare. The consultations were held in the form of two focus groups, one with young people who were at the time, or had been, patients of GOSH, and the other with their parents or carers and wider family members.
The report summarising key findings from these focus groups is being used in our planning work for patient-reported measures.
Comparing ourselves to other centres
Many of our clinical services provide outcomes data to national or international registries. These registries monitor incidence of disease, clinical management of conditions and treatment outcomes. Over time, national and international collection of data enables comparison with other paediatric centres on quality of services and the effectiveness of care. Several of the specialties that report to registries have access to this comparative data. Here are some examples:
- Cardiology and Cardiac Surgery
- Cleft Lip and Palate
- Intensive Care Unit
- Cystic Fibrosis
The specialised care we provide sometimes means that we cannot compare what we are doing with other UK centres. So we have looked for ways to compare our treatment effectiveness both against agreed standards or, where possible, with other organisations internationally to look at how we are doing over time. If agreed measures do not yet exist, this requires careful work to ensure that we are comparing 'like with like'.
We are leading an international benchmarking project with the aim of establishing a number of agreed outcome measures. The project is working with six specialties initially, but plans to include more specialties over time.