Developing a rapid feedback system to improve surgical outcomes

Mid Essex Hospital Services NHS Trust

  • Project led by Mid Essex Hospital Services NHS Trust in partnership with the Postgraduate Medical Institute at Anglia Ruskin University.
  • Focused on burns, microsurgery and cleft palate procedures at St Andrew's Centre for Burns and Plastic Surgery and the North Thames Cleft Service.
  • Aimed to provide a cost-effective way for surgical teams to monitor patient outcomes and reduce complications.
  • Developed a toolkit that supports streamlined data collection and analysis, and provides surgical teams with real-time feedback.

Mid Essex Hospital Services NHS Trust worked with the Postgraduate Medical Institute at Anglia Ruskin University to develop a web-based toolkit to help surgical teams to monitor patient outcomes and reduce complications from surgery, in a cost-effective way.

The toolkit supports streamlined data collection and analysis, and provides real-time feedback which enables teams to identify and share good practice, and to respond quickly to runs of excessive complications.

The team used an Agile approach to developing the software and worked with end users from the beginning of the process. They tested and refined the toolkit by using it to monitor specific outcome measures in three types of surgery:

  • burns: mortality following major burn admission
  • microsurgery: rates of return to theatre, flap failure, length of stay and time to heal without dressings
  • cleft palate: rate of wound breakdown and revision surgery.

Who was involved

The project team included clinical leads for each of the three types of surgery, plus experts in leadership and finance.


The team developed a functioning tool which can be used at a team level to monitor surgical outcomes. 

Surgical teams benefited from having access to a wider range of outcome measures which were tailored to their clinical area. For cleft palate surgery, for example, one outcome measure looked at clarity of speech after surgery.


The project team encountered many challenges, including difficulties with filling the project manager role and delays in the software development process which reduced the amount of time available for monitoring the impact of the tool in action.

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