Why Does the Writing in a Health Care Quality Report Matter?
Information is clear if the audience for that information can understand it. This simple rule poses a real challenge, because there are many possible audiences for a health care quality report and they may differ in background knowledge, literacy skills, and other characteristics that affect how easily they can understand the information you present.
Warning: Mismatch Between Reading Ability and Quality Reports
Many public reports on health care quality exceed the reading capabilities of the average American. An analysis of seven State report cards found grade levels ranging from ninth grade to third-year college, while the average reading level of Americans is somewhere around eighth or ninth grade. Moreover, literacy skills vary widely by age and socioeconomic status, so you cannot assume that materials that work for one audience will work for every audience. People in Medicaid programs, for example, tend to read at the fifth grade level or lower, while literacy skills for people age 65 and older are substantially lower than for the population as a whole.
This discrepancy between the difficulty of report cards and the average reading skills of consumers suggests that a large number of American adults would struggle to read and understand anything other than the simplest text. For that reason alone, it is critical to consider how you can implement the tips for making your information as clear and reader-centered as possible.
One Option: Use Intermediaries To Help Interpret Information
Sometimes, it is hard to explain all the concepts in a performance report in a way that would allow your intended audience to use the report without assistance. Moreover, because people have different learning styles, it can be helpful to present the same information in different ways.
If your written report card is likely to be too challenging for some members of your intended audience, you may want to consider recruiting and training people who can help members of your audience understand and apply the information in the report. These people, known as information intermediaries, represent an alternative strategy for delivering information on comparative quality. Learn more about supporting users in using information on quality.
 Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Health literacy: a prescription to end confusion. Institute of Medicine, Committee on Health Literacy, Board on Neuroscience and Behavioral Health. Washington, D.C.: National Academies Press; 2004.
 To learn more about literacy levels in the United States, review the findings of the National Adult Literacy Survey: Key Findings of the National Assessment of Adult Literacy. Available at http://nces.ed.gov/naal/kf_demographics.asp. The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. Available at http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483.