Bartolo Zingone

Page updated on June 4th, 2009

Heart surgeon, University Hospital “Ospedali Riuniti” Trieste

Bartolo Zingone works in a discipline in which outcome indicators have been used for many years. He is a heart surgeon at the University Hospital “Ospedali Riuniti” in Trieste. Therefore, he is certain about how essential is the use of these tools.

“For every patient we treat, it does not matter what pathology we are obliged to give an expected outlook. In order to know what these outlooks are, we need to measure them. Furthermore, measurement is an indispensable tool in improving treatment, health institutions and personnel: any improvement implies quantitative knowledge of the standard performance because only in this way is it possible to understand if there is or there is not an improvement and to look for the causes”.

However, Zingone is also well aware of the limits of outcome indicators. “They are the best on offer at the moment, above all in certain activities. They are extremely effective in measuring the final product and they provide us with good clues to the quality of the process by which it has been produced. However, they only portray the final outcome. This is the main problem that suggests these tools should be used only by professionals: they know the internal processes even when they are not clearly codified. If the indicators and their evaluations become a tool for improvement, then it is necessary that the professionals themselves take the lead”.

And the public? Don’t they have the right to be informed and know the results of these evaluations?

With due respect to the press and the right to information, which must be kept intact and free, I think that publishing them does not have the ability to really inform and allow the citizen to understand. In the end, the data translates into a classification. And, if the ultimate aim in measuring is to improve services, the risk is that this tool will produce the opposite effect. In fact, instead of working on the quality of the product, health care operators may decide to directly work on the indicators, thus removing services from those most at risk.

The danger that publishing produces distortions could then be greater than its benefit.

That does not mean that the public must not have access to information. But they could be taught. They could, for example, turn to specialists to receive all the detailed quantitative information regarding outcomes and processes of the health institutions where they work. In order to assure the credibility of this information, a third party might be used to generate information, such as an agency: in that way, the public would have access to quality information.