Public Reporting on the Quality of Healthcare: Emerging Evidence on Promising Practices for Effective Reporting

Main Messages

One size does not fit all: When it comes to public reporting on healthcare quality and performance, there is no one “best” approach. Design and dissemination of reporting products should vary depending on the specific context and audience. A particular format and distribution strategy that is effective in one set of circumstances will not necessarily work in another situation. The jury’s still out: While public reporting on health-system performance and quality has grown dramatically worldwide since the mid 1980s, there is little rigorous research on its impact. Evidence is particularly limited on which report formats and distribution strategies are most effective.

Know your audience: Agencies with a reporting mandate must find out what information their target audiences need and how they want to use that information. Understand why you are reporting: Agencies must define their objective in reporting. Why do they want to report? What, specifically, do they want to achieve? What impact do they hope their report will have? To evaluate the effectiveness of reporting, agencies need to understand what results they want before they can measure their efforts. Reporting agencies should involve stakeholders to define clear objectives, which will also decrease the likelihood of unintended consequences.

Cultivate the news media: Reportage in the news media can be an effective way for agencies to get their message out to a broad public audience. There is a fear that the news media may distort or sensationalize messages on health quality, but this has largely not been the experience in Canada. The problem, more often, is getting the attention of busy reporters who must choose what to report on from many competing stories. Agencies can increase the uptake of their information by cultivating relationships with reporters and providing them with clear messages to report.

Report cards may not meet your objectives: If the goal is to involve citizens in democratic accountability or quality improvement, agencies may first need to educate the public about its role in those activities. Reporting agencies may be further ahead to first produce and distribute information about how the health system is organized or what care patients can reasonably expect to receive if they have a particular condition.

Public reporting is only one piece of the puzzle: To increase accountability and improve quality within the healthcare system, reporting must be part of broader, ongoing efforts to build and nurture a relationship with the audiences intended to use information in reports. Blindly churning out reports is unlikely to have any sustained impact on healthcare system accountability or quality. Agencies with a reporting mandate must know their audiences, and must invest in educating those audiences about what the information in their reports means and why it’s relevant to intended readers.