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Project 7: RAFT Cardiac Output Monitoring Survey (COMS)

Project 7: RAFT Cardiac Output Monitoring Survey (COMS)

This is the first national project conducted by RAFT, a national umbrella group for anaesthetic trainee collaboratives.

This survey will for the first time describe the number, type and availability of Cardiac Output Monitors (COMs) in UK anaesthetic practice and attempt to assess the impact of national guidelines and CQUINs on their use and hospital episode statistics outcomes.


SHARC has given assistance to RAFT and COMS through:

- giving access to SHARC's implementation of BYOD data capture technology, deployed for this national project
- provision of the online data centralisation facilities through http://sharcgroup.org.uk/coms




Cardiac Output Monitors (COMs) are marketed as a means to individualise haemodynamic therapy in the peri-operative period.  National pre-requisite Commissioning for QUality and Innovation (CQUIN) payment schemes [1], NHS Technology Adoption Centre [2] and recent National Institute for Health and Care Excellence (NICE) technology recommendations [3, 4] have been produced to incentivise and drive implementation of this technology.  

A range of COMs exist, but it is unclear which are commonly used in UK anaesthetic practice and what effect publication of NICE guidance and the national pre-requisite CQUIN scheme has had on their uptake and implementation.  The Research and Audit Federation for Trainees (RAFT) is the new trainee research and audit collaborative that networks together an increasing number of regional groups.  The timing is right for us to deliver on a simple, rapid, innovative and important project that establishes our reputation and builds on our early success.


To conduct a cardiac output monitor survey (COMS) across the 90 acute trusts in our network 


1.Describes the current COM availability and 
2.Determine the effect of CQUIN payment schemes and NICE guidance in driving COM implementation

Data collection

Survey data collection will be during a single ‘hot’ week (30th June to 4th July).  The actual survey is thought to require only 1-2 hours of work during this time period.  

The local trust leads will be required to gather information in a number of ways:-

1.By actually counting and recording the COM type / number
2.By accessing departmental protocols / guidelines on local intranet
3.By using a ‘Stop and challenge’ interview with relevant departmental lead(s) for procurement / equipment.
4.By interviewing the Clinical Director / Business Manager etc.

Data will be collected using either a paper questionnaire or an electronic form: Bring Your Own Device (BYOD) data capture system pioneered by SHARC.

Hospital Episode Statistics will be collected (national figures) for the 6 month period before and 2 year period after the publication of NICE guidance on COMs (March 2011).

Data centralisation

All regional data centralisation will be through the SHARC BYOD data capture system or the SHARC website.  Deadline 18th July 2014.

Result dissemination

Results will be disseminated through national, regional and local trust presentations (regional meetings, local departmental audit meetings).


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