The perceived impact of public reporting hospital performance data: interviews with hospital staff

Abstract

Objective: To assess perceptions about the value and impact of publicly reporting hospital performance measure data.

Design: Qualitative research.

Setting and participants: Administrators, physicians, nurses and other front-line staff from 29 randomly selected Joint Commission-accredited hospitals reporting core performance measure data.

Methods: Structured focus-group interviews were conducted to gather hospital staff perceptions of the perceived impact of publicly reporting performance measure data.

Results: Interviews revealed six common themes. Publicly reporting data: (i) led to increased involvement of leadership in performance improvement; (ii) created a sense of accountability to both internal and external customers; (iii) contributed to a heightened awareness of performance measure data throughout the hospital; (iv) influenced or re-focused organizational priorities; (v) raised concerns about data quality and (vi) led to questions about consumer understanding of performance reports. Few differences were noted in responses based on hospitals' performance on the measures.

Conclusions: Public reporting of performance measure data appears to motivate and energize organizations to improve or maintain high levels of performance. Despite commonly cited concerns over the limitations, validity and interpretability of publicly reported data, the heightened awareness of the data intensified the focus on performance improvement activities. As the healthcare industry has moved toward greater transparency and accountability, healthcare professionals have responded by re-prioritizing hospital quality improvement efforts to address newly exposed gaps in care.