5. Public Reporting as a Quality Improvement Strategy

Regarding the least useful aspects,
most common answer was that the
report was not timely and the data
did not reflect current practices.
Other complaints included: use of
outcomes data without process of
care info; poorly standardized
coding, excessive complexity and
technical detail, attribution of deaths
after transfer, inclusion of
superfluous information.
Most respondents disseminated
report within hospital
~2/3 of respondents said the report
did not lead to any specific changes.
I-72
Barriers to constructive
use of outcomes data
persist, especially at high
mortality hospitals.
15. Funder of
Research/
Author,
Year 10. KQ3:Results 11. KQ4: Results 12. KQ5: Results 13. KQ6: Results 14. Summary
Report
Putnam
2006 131
Not Studied Not Studied For AMI: Over half the
indicators (29) presented
Physicians felt
some measures
The quality indicators are
generally acceptable to
Canadian
Institutes for
were rated as useful and are influenced by physicians, though they Health
credible. 17 were rated system and patient voiced the opinion that Research and
reasonable in principle, factors outside their they need to be
the Heart and
needing caution in control such as interpreted in terms of the Stroke
interpretation. Only 1 was physician
local context and patient Foundation of
considered unacceptable shortages that may factors.
Canada
(length of stay in ER). make follow-up
For CHF: 18 useful as it; difficult or
14 reasonable in fragmentation of
principle, and 2
care that make it
unacceptable
hard to coordinate
or assign
responsibility or
patient preferences
or resistance to
taking medications.
Rainwater
1998 132
~3/4 of respondents found at least
some aspect of the CHOP report
Not Studied Not Studied Not Studied Both NY and CA say
report cards are
U.S. Agency
for Health Care
useful, most frequently, as a means
distributed. Leaders at Policy and
for benchmarking performance. It
high mortality hospitals Research; No
was also useful in improving and
were especially critical. COIs
educating physicians about
Recent hospital report
importance of coding.
cards were rated better
than pioneering federal
efforts. A report based on
clinical data was rated
better, understood better,
and disseminated more
often to key staff than one
that was based on
administrative data.