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A major goal of public reporting is to improve quality. This includes not only the quality of care received by an individual who uses the information to make a better decision, but also the quality of care overall.

One way to contribute to this kind of improvement is to support consumers in talking about quality issues with their trusted providers. There is a difference between complaining to a provider about the quality of care one has received and discussing quality issues more generally with a provider.

• Complaining about care is a significant challenge for many health care consumers, who typically say they are uncomfortable telling their regular physicians that they are dissatisfied with some aspect of their care. They are concerned that the physician will become angry or annoyed, and that this will damage their relationship and could even negatively influence the quality of care they get.
• Discussing quality issues may be easier for some patients, and can be useful, especially if they are discussing the quality of care provided by someone other than the provider with whom they are talking.

People do become concerned when they see scores that are less than stellar in report cards. Report sponsors can play an important role by helping people initiate a fruitful conversation that is not confrontational. There is limited research on—or even much experience with—this approach, but it appears to be a potential use of comparative quality reports that can lead both to more active and engaged patients and higher quality care.

Example 1: Hospital Quality Report

Many consumers think it is their physician who chooses a hospital for them. A quality report can help them understand that they have a say in the choice if they or a loved one are going to be admitted to a hospital.

Encourage your readers to talk to their physician about variations in hospital quality they have noted in a report, especially on an issue important to them.

• If their regular doctor is the one who will admit them to the hospital, they can express concerns about problems in the hospital the doctor has suggested, or express an interest in going to a particular hospital, based on the quality data they have seen.
• If their regular doctor is referring them to a specialist who will make the admission, they can ask to be referred to a specialist who practices in the hospital they think has higher quality.

Example 2: Physician Quality Report

It can be harder to talk to a doctor about the care he or she provides, but you can suggest ways for patients to begin a conversation about a report on physician quality by being focused and non-confrontational.

EXAMPLE: Offering Patients Tools They Can Use With Providers

Title: Minnesota HealthScores Health Trackers
Sponsor: Minnesota Community Measurement
URL:

Minnesota Community Measurement’s Web site, which is called Minnesota HealthScores, rates clinics across the state on various aspects of patient care. The site uses its “teachable moment” to educate patients about some of the things they and their doctors could be doing to maintain and improve their health.

For example, this site provides “Health Tracker” tools for diabetes, vascular disease, and depression. A patient could use this tool at home and as a way to open a conversation with a doctor by saying, for example, “I came across this list of five things I should have checked regularly for my diabetes. Can we go through the list to see if I am up to date?”

Source: Minnesota Community Measurement. Minnesota HealthScores. Available at .