Academic journal article Health Care Financing Review

Public Reporting of Hospital Patient Satisfaction: The Rhode Island Experience

Academic journal article Health Care Financing Review

Public Reporting of Hospital Patient Satisfaction: The Rhode Island Experience

Article excerpt


As part of the movement to improve health care quality, increasing attention is being given to public accountability for health care providers, and efforts are being directed toward a national report card (Institute of Medicine, 2001). Performance reports have two complementary objectives: quality improvement (QI) and public accountability. In the hospital arena, QI efforts have tended to focus on internal processes, and performance measurement is used to provide reference points for gauging improvement and monitoring success of interventions. When health care performance is reported to the public, it is intended to demonstrate that providers can be monitored externally and that the health care system is accountable to patients. Moreover, when public reporting is comparative, it requires that organizational performance measurements are developed consistently across providers and presented to highlight variation.

The purpose of this article is to describe a collaborative process for mandated public reporting of comparative hospital performance in the State of Rhode Island that began with a public report of hospital patient satisfaction data. The article begins with an overview of current and recent public reporting of hospital data and the legislative mandate in Rhode Island. Next, the process of moving from mandate to reality--from vendor selection to designing and disseminating a public report--is described. Finally, key elements of the collaborative model that evolved in Rhode Island are identified and lessons learned from this process are discussed.

Hospital Patient Satisfaction Public Reporting

As part of a series of publications on health care quality, the Institute of Medicine (2001) published a monograph on public reporting, outlining an approach to a national report card for the health care system. An important objective of this work has been to focus attention on the need to make health care quality information accessible to the public. The conceptual framework proposed in "Envisioning the National Health Care Quality Report" emphasizes consumer perspectives on health care needs, including patient satisfaction. Recent public reporting efforts have focused on comparative health plan performance (New York State Health Accountability Foundation, 2001), health plan member satisfaction (Crofton, Lubalin, and Darbu, 1999; Guadagnoli, et al., 2000), hospital clinical performance, and the use of standardized data such as the Minimum Data Set and the Outcome and Assessment Information Set for public reporting on nursing homes and home health agencies, respectively.

Despite these national efforts, a review of public reports of hospital data (both print and Web-based) showed that there are relatively few reports that compare data by hospital or that are designed specifically for public dissemination, and even fewer that report patient satisfaction. A few States, including Rhode Island, legislatively mandate public reporting of hospital data. For example, Pennsylvania, Virginia, and Utah mandate that hospital cost and utilization data be publicly reported. Maryland has mandated public reporting of hospital clinical measures, planned for 2003. Other public reporting of hospital utilization data has been undertaken by business and health coalitions (e.g., Pacific Business Group on Health, Houston Healthcare Purchasing Organization). Three hospital and health systems publicly report hospital cost and utilization data (Colorado, Michigan, and Ontario, Canada), and one includes patient satisfaction (Ontario). Hospital patient satisfaction also has been publicly reported by five coalitions: (1) California Institute for Health Systems Performance, (2) Cleveland Health Quality Choice, (3) Massachusetts Health Quality Partners, (4) Niagara Health Quality Coalition, and (5) Southeast Michigan Employer and Purchaser Consortium. Recently, three other regions have joined with Michigan to form the Hospital Profiling Project and report patient satisfaction. …

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