Give People a Reason To Look at a Health Care Quality Report

Tell your audience why you are providing quality information. In particular, be specific about how they can benefit personally from using the report. Since many people are also likely to care about how comparative quality reports can help improve heath care for everyone, you can mention that as well. The research you did during your planning phase should help you identify the benefits that will resonate most with your audiences. (Learn about Early testing with your audience.)

Quality and Quality Information Matter

Your report and any related materials have to be explicit about why consumers and patients should pay attention to health care quality information when choosing health plans or providers.
Here are key messages to include in your materials:

  • The care you get depends on what plan/provider you choose.
  • Some plans/providers do a better job than others.
  • You may be surprised at how often people get care that is much less effective than it can and should be, even from people and organizations with a great reputation.
  • We know how to measure the health care different plans/providers deliver accurately and fairly.
  • Poor health care can have serious health and financial consequences for you and your family.
  • While your doctors have a big influence on your care, health plans, hospitals, nurses, other clinicians, and even health care managers can also make a big difference.

If you are reporting on hospitals, health plans, large medical groups, and other large-scale organizations, this last point is important. Many people attribute the quality of care they receive almost entirely to their doctors. They don’t realize how these other elements of health care can make a difference, even for a person with a very good personal physician.

Notice that the messages we provide do not use the word “quality.” In fact, the average member of the public isn’t very clear about what quality is, and may misinterpret it. That’s why it is useful to Provide a Framework for Understanding Quality.

Framing the Message To Capture Attention

In your report card, you can “frame” messages about quality by expressing them in a positive or negative way.

  • An example of a positive frame: "Use this information to choose the hospital that will offer the best care for you and your family."
  • An example of a negative frame: "Use this information to avoid the problems that can arise if you pick the wrong hospital."

In general, advertisers and marketers believe that messages that emphasize risks people face are more likely to get their attention.

Research on framing. Health care researchers have tested whether the way sponsors frame a message makes a difference. Specifically, studies have addressed whether the nature of the frame affects:

  • How well consumers understand health care quality information.
  • How much they value that information relative to other factors.
  • How willing they are to make trade-offs to get higher performers.

What did the studies conclude?

  • A study of health plan choice found that while people said they preferred to make a decision based on positively oriented measures such as the rate of preventive services, their actual decisions, in a hypothetical situation, were more affected by results on negative measures such as complications.[1]
  • A study on framing hospital information found that when quality information is framed in terms of helping people avoid risks in choosing a hospital, people understand it better, value it more, and are more willing to make tradeoffs to avoid risk.[2]
  • A study of nursing homes found that because people are already so fearful of nursing homes, using a negative frame for nursing home quality information made them unwilling to look at nursing home data at all.[3]

These findings suggest that when people need to be reminded that there is a risk of making a bad choice with bad consequences, it is appropriate to use a negative frame. In the case of hospitals, for example, a negative frame can be effective because many people believe they all offer about the same quality of care and don’t think about the risks of harm—not only in terms of resolving their condition, but in terms of patient safety and medical errors.

[1] Hibbard JH, Harris- Kojetin L, Mullin P, et al. Increasing the impact of health plan report cards by addressing consumer concerns. Health Aff (Millwood) 2000 Sep-Oct;19(5):138-43.
[2] Hibbard JH, Jewett JJ. Will quality report cards help consumers? Health Aff (Millwood) May-Jun;1997,16(3):218-28.
[3] Delmarva Foundation for Medical Care, Inc. American Institutes for Research. Framing Public Reporting: Determining whether publicly reported measures should be presented in a negative or positive construction. Report to the Centers for Medicare & Medicaid Services. January 31, 2005.

Also in "Communicating Key Information Upfront"

Page last reviewed November 2018
Page originally created February 2015
Internet Citation: Give People a Reason To Look at a Health Care Quality Report. Content last reviewed November 2018. Agency for Healthcare Research and Quality, Rockville, MD.
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