Assessing the performance of a consultant anaesthetist by control chart methodology

The performance of trainee anaesthetists has been assessed by control chart methodology, but while assessment of consultants' performance has been suggested, published reports are rare. In order to test the value of control charts, I monitored my insertion of arterial and central venous cannulae over 3 years, documenting success or failure both for the first pass of the needle and for the intended site of cannulation. The resultant control charts clearly show episodes of changed performance. It was necessary to modify the technique used to assess trainees, specifically with relation to definitions of success, failure and 'acceptable' failure rates. The information obtained from these charts is well suited to inform an appraisal or revalidation discussion with both reflective and assessment elements.