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Guidelines for Consumer-focused Public Reporting

Slide Presentation from the AHRQ 2008 Annual Conference

On September 10, 2008, Carol Cronin, made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (82 KB).

Slide 1

Guidelines for Consumer-focused Public Reporting

  • AHRQ Quality Indicators (QI) Users Meeting
  • Carol Cronin
    Informed Patient Institute
  • September 10, 2008

Slide 2

Background

  • National Quality Forum (NQF) Public Reporting Technical Advisory Panel (TAP)?
  • Part of NQF Steering Committee (SC)—Hospital Care 2007 project.
  • AHRQ-funded.

Slide 3

TAP Charge

  • "Recommend a Web-based approach for public reporting of acute hospital quality data that can be used, at minimum, to report the AHRQ Quality Indicators."

Slide 4

Scope

  • Focuses on reporting healthcare quality data from acute care hospitals in a Web-based format; though generalizable to other types of settings.
  • Intended primarily for use by sponsors of consumer-focused sites to enable reports that support consumer understanding and participation in care decisions.

Slide 5

TAP Members

  • Chair: Carol Cronin-Informed Patient Institute, Annapolis, MD.
  • Katherine Brown, Hospital Quality Alliance, Washington, DC.
  • Susan Dragoo, INTEGRIS Health, Oklahoma City, OK.
  • Judy Hibbard, University of Oregon, Eugene, OR.
  • Art Levin, Center for Medical Consumers, New York, NY.
  • Denise Love, National Assoc. of Health Data Orgs., Salt Lake City, UT.
  • Jeanne McGee, Mcgee & Evers Consulting, Vancouver, WA.
  • Deirdre Mylod, Press Ganey Assoc., Inc., South Bend, IN.
  • Ramesh Sachdeva, Children's Hospital and Health System, Milwaukee, WI.
  • Maribeth Shannon, California HealthCare Foundation, Oakland, CA.
  • Bruce Spurlock, CA Hospital Assesment & Reporting Taskforce, Roseville, CA.
  • Project Staff: Melinda Murphy-NQF Consultant.

Slide 6

Approach

  • Literature review.
  • Review of existing Web-based resources—Talkingquality.gov, Usability.gov.
  • Structured interviews with researchers, report sponsors.
  • Iterative development.

Slide 7

AHRQ Model Report

  • Designed to report comparative hospital QIs.
  • Developed by researchers including Shoshanna Sofaer—Baruch College.
  • Included testing with consumers.
  • Two resulting model reports:
    • Health Topics—individual QI indicators grouped into categories.
    • Composites—QI composites.

Slide 8

Report Sponsor Challenges

  • Understanding what constitutes a useful report.
  • Assuring reports support consumer understanding of quality and healthcare choice.
  • Conveying information that provides the right amount of information at the right time in a way that resonates with target audiences.
  • Customization of results to the audience.

Slide 9

TAP Principles

  • Public and other stakeholders have right to access objective measures of quality provided by organizations in/from which they receive care, deliver care, purchase care, or provide funding/regulation and to receive the information in an understandable format.
  • Use of the public reporting guidance can/should provide incentives for quality improvement.
  • Information should be displayed for an array of common, cross-cutting conditions, all ages and be available across organizational settings/service lines and over time.
  • Awareness and understanding of inherent values and biases is important to responsible reporting.

Slide 10

Goals of Consumer-focused Public Reporting

  • Increase consumer motivation to use public reports by making reports more understandable and relevant.
  • Provide objective, unbiased, actionable and evaluable performance information to the public.
  • Improve quality of care provided across the industry; and
  • Stimulate further evolution of the quality and comparability of public reporting at the organization, state and national levels.

Slide 11

Guidance for Consumer-focused Public Reporting—Overview

  • TAP identified guidelines for public reporting in 7 areas.
  • Also included Implementation Considerations that amplify the guidelines.
  • Assessed AHRQ Model Reports against guidelines.
  • Includes AHRQ Model reports in Appendix.

Slide 12

Guideline 1: Purpose of Web-based Report

  • Identify the purpose of the Web-based report, its intended main consumer audience(s), and how the report will be made known to the audience.
    • Nature and purpose.
    • Who is the audience? What are their info needs?
    • Who are secondary audiences and how will their unique needs be addressed?

Slide 13

Guideline 2: Process of Developing the Web-based Report

  • Develop the Web-based report using a transparent process that involves consumers and other relevant stakeholders.
    • Stakeholders include: sponsors, consumers, organizations being measured.
    • Establish governance/decision making rules.
    • Opportunity for those being measured to preview and correct errors.
    • Consumer usability testing before, during, after.

Slide 14

Guideline 3:Introduce concept of quality

  • At the beginning of the report, set the stage by communicating what quality is, how quality varies and how making quality comparisons can be of value to consumers.
    • Explain that quality varies within and across orgs.
    • Use consistent, simple and familiar language.

Slide 15

Guideline 4: Meaningful Measures

  • Ensure that measures included are meaningful to consumers, transparent, and meet widely accepted, rigorous criteria including importance, scientifically acceptable, feasible and usable.
    • Relevant to consumers.
    • Demonstrate variation.
    • Provide information that reflects overall quality.

Slide 16

Guideline 5: Data Presentation

  • Present and explain data clearly and objectively in ways that help consumers understand and use it.
    • Data should be evaluable.
    • Consistent reporting (low or high scores better)รพ
    • Use stories to illustrate meaning.
    • Allow users to see what they want.

Slide 17

Guideline 5: Data Presentation (cont.)

  • In presenting comparative quality information.
    • Use tools such as rank ordering, symbols that help user quickly discern performance.
    • Include benchmarks if possible.
    • Provide risk-adjusted rates into categories using words such as "better", "average."
    • Label indicators in everyday language.
    • Limit use of statistics that are difficult for consumers to understand.

Slide 18

Guideline 5: Data Presentation (cont.)

  • In presenting information from composite measures:
    • Report all measures that comprise the composite.
  • In providing contextual/decision support:
    • Provide clear contextual information.
    • Provide clear explanation for missing data.
    • Consumer test.
    • Use reasonably current data and display dates covered.
  • In presenting technical documentation:
    • Include detailed measure definitions, specs etc.
    • Provide details about the methodology.

Slide 19

Guideline 6: Report Usability

  • Ensure that design and navigation features enhance report usability.
    • Organize information to let users make choices.
    • Provide engaging format/easy navigation.
    • Easy to skim.
    • Easy to print.
    • Test with audience.

Slide 20

Guideline 7: Regularly Review and Improve Reports

  • Regularly review and assess reports to ensure their effectiveness and currency.
    • Assess use and impact.
    • Involve stakeholders in revisions.
    • Use learnings to drive improvement and usefulness of performance measures and public reporting field.

Slide 20

Research Recommendations

  • Impact of public reporting.
  • Content of public reporting.
  • Unintended consequences.
  • Understanding issues related to cultural and linguistic needs.
  • Effect of public reporting on quality improvement.

Slide 22

Project Status

  • Public comment period: June 2008.
  • Final NQF member voting: Aug. 2008.
  • Consensus Standards Approval Committee (CSAC)/Board consideration: Sept. 2008.
  • Publicly available: Late 2008.

Slide 23

For more information:

Current as of January 2009

Internet Citation:

Guidelines for Consumer-focused Public Reporting. Slide Presentation from the AHRQ 2008 Annual Conference (Text Version). January 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/annualmtg08/091008slides/Cronin.htm

 
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