Providing Detail in Quality Reports for Those Who Want It

Report sponsors always want to tell potential users more about their report than they can fit on an introductory page. The reality is that you can say more, but you have to put it in later pages so that the comparative information remains prominent in your report.

Keep this distinction in mind:

• What goes on the front page is material you want everyone to read.
• What goes in the “back” is information that only some users will access and read.

While consumers may not be interested in detailed information, health professionals and consumer advocates are likely to be interested and will read it carefully. In addition, consumers often say that they want to know you are willing to provide details, especially about how you handled and collected the data, because it is a sign you are not hiding anything from them.

This page discusses some of the details you should consider providing:

• The Sponsors and Endorsers of This Report.
• The Health Plans or Providers That Are Being Rated.
• Where the Data Came From.
• Other Technical Details.
• More Information About Quality.

The Sponsor and Endorsers of This Report

In addition to mentioning your sponsor on the front page, you can use a page within your report to provide:

• Additional detail on the sponsor, such as:
  • An explanation of how comparative quality reporting is related to your mission.
  • Brief descriptions of other activities.
  • Relevant expertise.
• A list of organizations in the community that have endorsed the report; you can also provide letters of endorsement if you think they will promote trust.
• A list of board members of the sponsoring organization (particularly useful if it is a multistakeholder entity).
• Contact information for the sponsor’s staff, perhaps including the name of the person who takes the lead on reporting.
• In Web-based reports, you can also add:
  • A functionality to e-mail questions about the report (assuming you have the resources to monitor the inbox and respond quickly).
  • A functionality to provide more formal feedback on the report via a short survey.

The Health Plans or Providers That Are Being Rated

Your report can provide contact and descriptive information about each of the organizations being rated in the report.

Contact Information

For each organization, list:

• Common business names.
• Telephone number.
• Web site URL.
• Physical address.

Contact information permits the user to get further information about plans or providers of particular interest. An address is important for those users who want to visit a facility ahead of time. This is extremely common for people choosing a nursing home, since it will be the actual residence of the patient. It may also be of interest to hospital patients, especially those seeking special units such as maternity or pediatrics.

Descriptive Information on Individual Organizations

Descriptive information is often a highly useful supplement to quality ratings. To learn about descriptive measures that speak to the quality of different types of providers, go to Measures of Quality for Different Health Care Settings.

Other descriptive information may be viewed as less indicative of quality but nevertheless relevant to someone making a decision. This includes information on:

• Location.
• Access to public transportation.
• Hours of operation.
• Whether clinicians and staff speak languages other than English.

Descriptive Information on Organization Types

Some kinds of services and facilities are less familiar to the public than others. Examples include home health, hospice, and renal dialysis facilities. Sponsors of reports that focus on these types of providers should offer consumers additional information about:

• What these facilities do.
• What services they provide and to whom.
• What kind of staff work for them.
• How they are financed.

Where the Data Came From

While you may not want to organize your data by its original source, you do want to briefly tell people where and how you got the data.

Here are some points to emphasize:

• The sponsor used a standard method to collect data for all organizations included in the report.
• The data are either collected independently or audited. Users are likely to be skeptical if you say the organizations rated are collecting the data themselves, unless you reassure them that the data are also audited by an outside body.
• The scores themselves are generated by the sponsor or another independent group.

On the front page, you can’t devote more than a couple of lines to communicating these points. However, you can let users know that they can find more information about this question inside the report. In a Web-based report, offer a link to help anyone who wants to go to that information right away.

Other Technical Details

Technical details do not belong in the front of the report. You may include a few technical items around data displays, but it’s best to provide extensive detail about the technical aspects of quality information on later pages so that those who are interested can access it. Even though consumers are unlikely to look at this information, the fact that it is there is reassuring to them.

Consider including the following information:

• The process and criteria you used to select measures for inclusion.
• Where to get details about the technical specification of each measure. If you have just a few measures, this might fit within your report. If you have many measures, it may be more appropriate to include a link or citation for a resource where people can get that information.
• The source of the data for your measures, your reasons for trusting these sources, and any significant caveats.
• If you are sharing survey information:
  • The minimum sample size for each organization.
  • What kind of people are included and excluded from the sample.
  • How the survey is administered.
  • Who gets the completed surveys and aggregates the responses. This is important because consumers are suspicious if the rated entities get the data back and aggregate it before providing it to the sponsor.
• How data are validated and/or audited.
• How you constructed scores.
• How you assigned different organizations into categories of performance, if you do this.
• Whether the rated organizations got a chance to review their data before it was included.
• If you’ve invited organizations to comment: What organizations had to say about the data and any steps they have taken to improve their performance.

Be sure to use consumer-friendly language that is readable by someone with less than a high school education. This means defining terms as you go along. While most consumers will not read this material, it is your responsibility to make it as accessible as possible for those who do.

More Information About Quality

At the front of your report, you may have provided limited information about the meaning of the term “quality” and why it is important. You can discuss this topic more thoroughly in later pages of your report, going into greater depth on issues such as:

• How quality can be defined.
• How we know that quality varies and is sometimes poor.
• How and why quality makes a difference.
• What happens when people make decisions without taking quality into consideration.

You can also discuss related topics such as your motivation for sharing quality information with the public and your hopes that doing so will lead health care organizations to work on improving their performance. Many consumers intuitively realize that this is an important reason for quality reports—especially now, when concepts of “transparency” and “accountability” are being discussed across many sectors of society.

Also in "Explain and Motivate"

• Why Numbers and Graphs Aren’t Enough
• Communicating Key Information Upfront
• Providing Detail for Those Who Want It
• Taking Advantage of the “Teachable Moment”
• Supporting Consumers in Using the Information