To support consumer engagement and improved quality in healthcare, the National Quality Forum (NQF) endorsed guidelines for consumer-focused, internet-based public reporting. These guidelines will assist report sponsors to present information about hospital quality in an evidence-based and consumer-friendly format that can be used to make informed decisions about healthcare.
Consumers do not always seek out or use the information available to guide their healthcare choices. For the most part, public reports have been difficult to understand and use, have not adequately communicated what quality of care is, and have not convinced consumers to pay attention to quality.
Evidence suggests that healthcare quality reports and public report cards that contain conflicting information and are poorly constructed may hinder consumers’ ability to use the information presented and may lead to decisions inconsistent with their goals. This highlights the need to identify effective public reporting strategies to help change these outcomes.
“NQF endorsement of these guidelines will help ensure public reporting of performance continues to be an effective strategy to promote improvements in healthcare quality by making reports useful to the general public and credible to health professionals,” said Thomas Hartman, co-chair of NQF’s steering committee on hospital care and vice president of health care quality improvement at IPRO in New York.
The seven endorsed guidelines are intended for use by organizations that sponsor and publish public reports such as federal and state governments, consumer organizations, hospital accrediting organizations, business coalitions, and hospital associations. The guidelines are intended to be used for reporting quality performance of U.S. hospitals, but can be adapted for consumer public reporting of care in other settings.
The goals of the guidelines for public reporting are to help report sponsors produce consumer-focused public reports that are more understandable and relevant; provide actionable, and evaluable performance information; motivate efforts to improve the quality of care provided across the industry; and stimulate further improvements to public reporting.
These consumer-based public reporting guidelines achieve these goals by helping organizations that sponsor public reports to – identify the purpose and the intended audience of the report; use a transparent reporting process that involves relevant stakeholders; educate consumers about quality; use measures that are transparent and rigorously tested; present and explain data clearly and objectively; ensure the design of the report helps consumers use and navigate the information presented; and regularly assess and review the contents and relevance of the report.
1. Identify the purpose and audiences of the web-based report
Studies suggest consumers who do not use public reports on quality in healthcare are not doing so because they believe the information is too complex and irrelevant. This guideline aims to help the report developer consider information about the consumer such as age, culture and healthcare literacy so information can be presented in a more relevant way.
2. Use a transparent process that involves stakeholders
This point guides report developers to involve stakeholders such as consumers, healthcare providers and policymakers in defining the scope, format, and goals of the report as well as providing feedback on the language and messages. Stakeholder input at the outset of the project helps ensure the report is relevant and useful.
3. Set the stage by communicating information about quality
For a public report to be helpful to consumer decision-making, consumers must understand what quality in healthcare means and how to use the report to make information decisions about care. This guideline helps report developers convey the meaning of quality care in context of the report and in ways that are beneficial to the consumer.
4. Use measures that are transparent and meet widely accepted, rigorous criteria
For a public report to be credible and useful, the data within the report must be reliable and trustworthy. This guideline aims to make sure the measures selected to describe and publicly report performance are widely accepted and go through a rigorous, standardized and transparent evaluation process such as the NQF’s formal consensus development process.
5. Present and explain the data
A public report should help consumers comprehend healthcare quality information and connect with it in a way that enables them to select the best option for themselves. This guideline aims to help developers of public reports present otherwise complex and unfamiliar information in a way that that is understandable and helpful.
6. Ensure the report design and navigation enhance usability
The format of the report should provide clear navigation clues and make it easy to locate and print information for later use. Setting clear goals and involving the target audiences in design and testing is important to developing a report that is responsive to audiences.
7. Evaluate and improve the report
Report developers must regularly review and assess their quality information for relevance, accuracy and consistency. Periodic analysis and review will assure the continued relevance and usability of the public report.