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About TalkingQuality


NOTE: The contract that supports the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program, as well as the TalkingQuality Web site, expired on June 27, 2012. The TalkingQuality Web site will be unavailable until the new contract is awarded. In the meantime, if you have questions about how to report CAHPS data, please call the CAHPS Technical Assistance Line at 301-427-1017. The Agency for Healthcare Research and Quality is now working to award a new CAHPS contract, and when it is in place, the TalkingQuality Web site will be restored.



Purpose of TalkingQuality: To Improve Consumer Reports

TalkingQuality is a comprehensive resource and guide for organizations that produce and disseminate reports to consumers on the quality of care provided by health care organizations (e.g., hospitals, health plans, medical groups, nursing homes) and individual physicians.

Sponsors of consumer reports share a common mission: Improving the quality of care that consumers receive. They also share a common challenge: How do you convey comparative information about health care quality in a way that achieves the following objectives?

  • Consumers are motivated to use it.
  • Consumers can understand it.
  • Consumers can apply the information to their own health care choices.

TalkingQuality was created to help you answer this question. It offers:

  • Innovative ideas for communicating complex information on health care quality to consumers,
  • Information on the latest research findings, and
  • Real-world examples to illustrate various approaches and concepts.

While this site focuses on the challenges and process of consumer reporting, much of the guidance applies equally well to organizations producing reports on health care quality to drive quality improvement and to inform other audiences, such as providers of care, payers, employers, and other stakeholders.

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How TalkingQuality Can Help You

It's not easy to talk to consumers about health care quality. We can all tell stories about our own personal experiences with health care and convey our subjective impressions. But it is quite another challenge to sum up in an objective way what we know about the quality of health plans and providers in terms of their effectiveness, patient-centeredness, safety, timeliness, equity, and efficiency. [1]

The issues and the data are complex, confusing, unfamiliar, and abstract. As a result, much of the information about quality that is currently available to consumers is hard to understand and even harder to use when making a health care decision.

Although it may seem straightforward to report information to the public, many report sponsors have found that doing it right takes planning, insight into the tasks that consumers face when making choices, and the ability to transform data into actionable information.

If you've taken on this challenge, TalkingQuality can make your job easier.

Expert Advice and the Best Available Evidence of What Works

TalkingQuality will walk you through the decisions you have to make when developing and disseminating a quality report and give you practical advice based on what has been shown to work best. We've pulled together and organized ideas and advice from experienced sponsors, respected researchers in the field, and experts in health communications. We update the site periodically to let you know what's new in quality reporting.

Examples

To produce TalkingQuality, we've combed through many reports to find innovative and effective ways to present and describe performance data. Also, the site includes a collection of consumer reports on quality called the "Report Card Compendium." You can use this searchable database to learn what's happening in your market, see how other organizations present data, and get ideas for communication strategies you'd like to emulate (or avoid). .

Help in Setting Achievable Goals

This site will support you in setting reasonable goals for your reporting initiative and assessing your progress so that you can determine how to improve your report and manage the expectations of funders, partners, and the media. Over the past decade or so, some projects have been deemed failures because they did not achieve objectives that were, in hindsight, unrealistic. One important purpose of TalkingQuality is to help you figure out what to expect from your audience and what it will take to effect measurable change.

A Venue for Sharing New Findings.

The consumer reporting field is hindered by the limited ways in which we can learn from each other. We invite you to tell us about your experiences with quality reporting and share findings from your own work (including evaluation reports) so that we can incorporate what you have learned into this site. Write to us at talkingquality@ahrq.gov.

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Common Elements of Report Cards

The public reporting of health care quality began in the early 1990's with a government-sponsored report on hospital mortality and a handful of local initiatives. Since that time, health care performance reports – commonly known as report cards -- have spread across the country. They are now produced by a variety of public, nonprofit, and commercial organizations, all seeking to educate and inform health care consumers about their options with respect to health plans and providers of care, such as physicians, nursing homes, hospitals, and medical groups. Health care report cards encompass a wide range of printed and electronic documents that present comparative information on the quality of different types of health care organizations. While they may vary in size, media, and content, these reports share some important common elements:

  • Consumers as audience. The reports are aimed at an audience of health care consumers: health plan enrollees, potential or actual patients, people eligible for Medicaid or Medicare, employees, or the public at large. Similar reports are also developed for employers, plans, providers, regulators, and policymakers, all of whom are important decision makers as well. But in the context of TalkingQuality, report cards refer to documents or Web sites intended for use by consumers.
  • Purpose. The reports are intended to support consumers in making informed choices about their health care, to increase the public accountability of health care organizations, and/or to encourage providers and plans to improve the quality of care they deliver.
  • Quality measures. The reports contain information on how well health care providers or plans perform on specific standardized indicators of quality, such as the percent of hospital patients receiving recommended care, patients' reports on doctors' communication skills, or the State's assessment of a nursing home's compliance with established standards. Some reports also include other types of information, such as costs.
  • Comparative information. The reports show how the providers or plans perform relative to each other and/or a benchmark of some kind. The benchmark may be an average, a standard, or a very high level of performance that has actually been achieved.

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How Report Cards Differ

While health care report cards share some common features, they can vary in significant ways. TalkingQuality aims to help report sponsors understand their options and choose strategies that suit the information they are presenting and the needs of their audience.

  • The kinds of health care organizations being compared. Each sponsor has to decide, with its stakeholders, what kind of health care organization to focus on in a report. This decision is influenced by many factors, including legislative mandates, the needs of local health care consumers, the structure of the local health care market, the availability of appropriate measures and data, the cooperation of local health care organizations, and the interests of the sponsoring organization(s).
  • The measures. Report cards can present a wide range of quality measures. Moreover, some reports include many measures, while others focus on a limited number. The type and number of measures depend on the kinds of organizations being compared, legislative requirements, the information needs of the intended audience, the number and nature of standardized measures that are available, and the availability of reliable data.
  • Explanatory text. Reports differ in the amount of information provided to explain what measures mean, why they are important, and how to interpret and use the results. Some reports provide a great deal of information, while others are brief.
  • Level of detail. Reports can summarize the data in an effort to make the information more accessible and understandable, or offer detailed information so that users can decide for themselves what to focus on. Some reports accomplish both goals by letting users “drill down” into the details they want without having to see the ones they do not want.
  • Data displays. Reports rely on several different approaches to display data. Some show only the data itself, but the more common strategy is to use a graphic format (e.g., bar charts) or a table with symbols and/or words that represent the performance of organizations or providers relative to each other or a benchmark.
  • Decision support. All report cards are intended to help consumers make more informed decisions. Some tackle that goal through design choices and features that help consumers use the information to make decision. Examples include presenting the information in a more usable format, helping users identify their priorities, and providing them with tools designed to help them narrow down their options or consider quality information along with other factors.
  • Media. Until recently, most reports were printed. However, it is becoming increasingly common to publish report cards on Web sites, some of which are searchable or interactive in other ways.
  • Length and size. Report cards vary widely in appearance and in the depth of information they present. Printed reports range from brochures and small booklets to thick bound documents and pages incorporated into comprehensive benefits materials. Some Web-based reports are simply a one-page PDF file while others offer many pages of searchable and/or customizable information.

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Developers of TalkingQuality

The TalkingQuality Web site builds upon a site originally launched in 2001. The 2009 release of an updated and expanded site is sponsored by the Agency for Healthcare Research and Quality (AHRQ) through a contract with Westat, a research firm in Rockville, Maryland. A team with expertise in public reporting developed the new site and will continue to maintain it through 2012. The team works with reporting experts involved in AHRQ's CAHPS Consortium as well as an Editorial Board composed of experienced report sponsors and reporting experts.

The original TalkingQuality Web site was developed in 2000 by the Work Group on Consumer Health Information under the auspices of three Federal agencies: the Centers for Medicare & Medicaid Services, the Agency for Healthcare Research and Quality, and the Office of Personnel Management.

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Information Sources

The material in this site is based on a review of the literature as well as interviews and publications (some unpublished) provided by a variety of sources, including:

  • Experienced sponsors of consumer reports on quality.
  • Experts and researchers in the field of quality reporting.
  • Researchers in related fields, such as linguistics, health communications, health promotion, disease prevention, and marketing.

Findings from specific research studies are identified with footnotes.

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[1] These six aims of quality health care are defined in the Institute of Medicine's report, Crossing the Quality Chasm.

 


NOTE: The contract that supports the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program, as well as the TalkingQuality Web site, expired on June 27, 2012. The TalkingQuality Web site will be unavailable until the new contract is awarded. In the meantime, if you have questions about how to report CAHPS data, please call the CAHPS Technical Assistance Line at 301-427-1017. The Agency for Healthcare Research and Quality is now working to award a new CAHPS contract, and when it is in place, the TalkingQuality Web site will be restored.

 

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