Mandatory Public Reporting: Build It and Who Will Come?

Harvard Medical School, Boston MA, USA.
Studies in health technology and informatics 01/2011; 164:346-52. DOI: 10.3233/978-1-60750-709-3-346
Source: PubMed


Rates of healthcare-associated infections (HAI) are being reported on an increasing number of public information websites in response to legislative mandates driven by consumer advocacy. This represents a new strategy to advance patient safety and quality of care by informing a broad audience about the relative performance of individual healthcare facilities. Unlike typical consumer health informatics products, the target audience and targeted health behaviors are less easily defined; further, the impact on providers to improve care is unknown relative to other incentives to improve. To address critical knowledge gaps facing all state agencies embarking on this new frontier, we found it essential and straightforward to recruit the assistance of university research faculty from a variety of disciplines. That interdisciplinary group was quickly able to define a 5-year applied evaluation research agenda spanning a progressive set of crucial questions.
Citation: Bell S, Benneyan J, Best A, Birnbaumb D, Borycki EM, Gallagher TH, Goeschel C, Jarvis B, Kushniruk AW, Mazor KM, Pronovost P, Sheps S. Mandatory public reporting: Build it and who will come? Studies in Health Technology and Informatics 2011;164:346-52. DOI: 10.3233/978-1-60750-709-3-346

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    ABSTRACT: Purpose ‐ The purpose of this paper is to discuss the reporting of quality of care in hospitals. Design/methodology/approach ‐ The paper takes the form of a narrative review. Findings ‐ The American Federal Agency for Healthcare Research and Quality recently conducted a funding opportunity in recognition that the science of public reporting was insufficiently understood, which underlies relatively weak impact to date of public information web sites on hospital quality and safety. Whether the fundamental purpose of such web sites is to inform consumer choices or to stimulate facility leadership toward accelerated quality improvement, which relates to which metrics would be the most appropriate, and whether public audiences perceive concepts of evidence-based best practices differently from professional audiences, all remain in question. Whether reporting physical harm of adverse events is the best metric, or whether damage to dignity and trust should be included, or whether more holistic measures of institutional culture would be even more meaningful remain in contention. While it is premature to set standards unifying how and what hospital performance measures should be displayed on public information web sites, there are existing efforts to ensure developers can learn from the natural experiment afforded by the current abundance of independently developed North American reporting programs, league tables and public information web sites. Practical implications ‐ Developers of public policy and of electronic health information systems can benefit in terms of efficiency and effectiveness by capitalizing on the recent work of several interdisciplinary teams. They can benefit from the generic approach used by some who are attempting to harmonize the broad range of public health reporting programs' data flow into one use case model capable of accommodating all reporting streams, and from others who are applying evidence-based criteria to rank public information web sites while also evaluating performance of scoring criteria they are developing from broad principles acquired from various cited sources. Originality/value ‐ Public trust in healthcare facility quality and safety has fallen into mistrust, and the information web sites developed to address that consumer issue are known to have problems in ease of use, believability and helpfulness. This paper describes recent North American projects that acknowledge those problems but also provide potential paths toward solving them.
    No preview · Article · Jul 2013 · Clinical Governance An International Journal