OBJECTIVES: Outpatient services in Germany are less controlled by external quality assurance programs. Comprehensive outcome data for benchmarking or health-care decision-making are missing e.g. for day case surgery. A quality-of-life instrument specific to hernia repair with mesh has been recently proposed (Carolinas Comfort Scale, CCS). This study evaluates the integration of CCS as part of a multicentre quality assurance scheme for outpatient surgery.  METHODS: Sixteen ambulant centres developed a web-based quality assurance scheme for hernia day surgery in Germany. In an evaluation phase, all patients which were intended to treat with 3-dimensional meshes, were registered with consensus into a database through a web-based portal. CCS questionnaires were mailed to patients 4 and 12 weeks after surgery. Patients were requested to send pseudonymized responses to an independent party for inputting answers into the database. Clinical examinations were made 4 and 12 weeks postoperatively. Additional follow-up is planned 52 weeks after surgery. CSS consists of 23 questions in 7 activity- categories and 3 dimensions: sensation of mesh, movement limitations, pain.  RESULTS: During the first year (Oct 2009 to Sept 2010) 1429 patients were registered (1271 male, 158 female, median age 53 years) and treated for primary (88%) or recurrent (11%) hernia. 1300 (90%)/1246 (87%) patients were clinically reviewed 4/12 weeks after surgery. 1072 (75%) /1002 (70%) questionnaires were retrieved 4/12 weeks after surgery. Patient satisfaction rate was 98%. CCS scores are shown to be decreased from 4 to 12 weeks in all dimensions (Sensation: 0.51 to 0.35, Movement: 0.40 to 0.20, pain: 0.45 to 0.26). CONCLUSIONS: CCS, a short, hernia-specific quality-of-life questionnaire, is easy to use and well accepted by patients. It is shown to be a feasible instrument to evaluate patient reported outcome after day-case hernia surgery in a web-based multicentre quality assurance system.