Provider Performance Report Cards

Provider Performance Report Cards

By: Patrice L. Spath
Brown-Spath & Associates

The development and dissemination of health care provider report cards is on the rise. The impetus for this new found interest is three-fold: (1) consumers are concerned about managed care's impact on health care quality; (2) providers want to assure consumers that they have superior health care services; and (3) the presumption that better informed consumers will make more prudent health care decision choices.

Public release of provider-specific performance measurement data is a relatively new phenomenon and many health care organizations have yet to fine-tune their efforts. The first public report card was produced in January 1994 when Methodist Hospital in Indianapolis took an unprecedented step in sharing its clinical outcome and length-of-stay data with more than 70 local business and health care purchasing leaders. In the few short years since 1994 there has been a dramatic increase in the public release of similar provider-specific data. However, health care organizations are ill-prepared for this public scrutiny of their measurement data.

Health care performance measurement activities have traditionally been undertaken to provide individual caregivers and facilities with the information necessary to improve internal processes. Measures of health care performance are now being combined with other data to create publicly distributed report cards. Creation of such reports is not without its challenges! Even clinicians find the intricacies of health care structure, process and outcomes can make the simplest performance measure a bewildering yardstick of quality. The general public cannot be expected to evaluate complex clinical data to assess health care quality. People are most likely to base decisions about quality on the factors they can personally measure.

Health care providers can't just give consumers data showing the results of internal quality measures and expect them to make purchasing choices. Service quality ratings are what consumers want to know! Ford Motor Company doesn't share its productivity cycle times with its customers and say "This is a measure of our quality. This should convince you to buy our cars!" No, they say "Quality is Job One" at Ford and then proceed to tell about the car's gas mileage rating, ride comfort, safety record and other service quality ratings which interest their customers. Health care providers must do the same .... give customers information about the factors they are most interested in. Sophisticated process and outcome measurement data is unlikely to fulfill the needs of the general public. Researchers have found that compassion, communication skills, and respectful listening rank high on most consumers' lists of what they look for when selecting a health care provider. The work being done by the Foundation for Accountability (Portland, OR), a nonprofit organization involved in identifying consumer-focused quality measures, has shown that people confuse service quality (convenience, friendliness) with clinical quality (the outcomes of their care)

When designing provider report cards for the people in your community, planning is an important first step. During the planning phase carefully define the purpose for the report card, e.g., Who is the target audience for this report? What do you want them to learn? What actions, if any, do we expect them to take after gaining this new knowledge? The answers to these questions will influence what information is included on your consumer-oriented report card and the data presentation style. Here's a few issues to consider when presenting your performance measurement data to the public:

Multiple media presentations are best (hard copy reports, Internet-accessible data, videos, newspaper articles, etc.)
It is helpful if consumers have access to a live person (i.e., by phone) to answer their questions about the performance measurement data.
The amount of data presented on report cards should be limited in number to keep from overwhelming the consumers' ability to assimilate the information.
When clinical outcome data are made available to consumers they should be accompanied by explanatory information.

Consumer-oriented health care report cards must be simplified to allow for better interpretation by the general public. Even if report cards include important measures of quality, people will dismiss the information if they do not understand it.

A new book published by Jossey-Bass/AHA Press, "Provider Report Cards: A Guide for Promoting Health Care Quality to the Public," provides a succinct overview of the measures of performance that providers should include in their public-oriented report cards and pitfalls to watch out for when sharing performance data. In this book, health care providers learn how to measure the success of their public report card initiatives and what resources are necessary for creating the report card, including the design of Internet-accessible performance reports. One chapter is devoted to a discussion of the liability hazards to avoid when sharing performance measurement data with consumers. To order "Provider Report Cards: A Guide for Promoting Health Care Quality to the Public" call Jossey-Bass at 1.800.956.7739 or you can order the book online at their web site: www.josseybass.com

To Learn More: Patrice L. Spath is available for inhouse presentations on this and other health care quality and resource management topics. For further details, visit Brown-Spath & Associates on the web at: http://www.brownspath.com or write to: Brown-Spath & Associates, PO Box 721, Forest Grove, OR 97116.

Visit the web site of Brown-Spath & Associates ( www.brownspath.com ) for the latest information on health care quality and resource management, free up-to-date articles on contemporary performance improvement topics and invaluable training resources. Our web site is updated at least quarterly, so be sure to return often!

Brown-Spath & Associates PO Box 721 Forest Grove, OR 97116-0721
Phone: (503) 357-9185