Conveying Information On Healthcare-Associated Infections to the Public: Findings From Consumer Research

Theoretical Background and research questions/hypothesis: One of the Department of Health and Human Services’ priorities is to reduce Healthcare Associated Infections (HAIs), a significant cause of morbidity and mortality in the U.S.  To this end, the Centers for Medicare & Medicaid Services (CMS) will require hospitals to report selected HAIs as part of the Hospital Inpatient Quality Reporting Program, adding to the 55 hospital-specific measures of quality currently reported publicly on the Hospital Compare website.  Public reporting is intended to encourage hospitals to improve the quality of care and to help consumers make more informed decisions. However, prior research suggests that consumers do not understand quality in the same terms that professionals do, have difficulty accurately interpreting statistics about rare events in discrete patient subgroups, and do not understand how reported quality measures affect them.  Before publicly reporting the new information on Hospital Compare, CMS has therefore contracted with L&M Policy Research (L&M) and its partners to conduct consumer research to ensure that the information is presented in a way that consumers can understand and use.  

Methods: Because HAIs raise questions about hospital safety not currently addressed on Hospital Compare, the L&M team will first conduct formative research to explore consumers’ perceptions, knowledge and understanding of this topic and options for effectively integrating the information into the existing website.  The team will conduct the exploratory research using focus groups, an effective tool for gathering information from a cross section of potential users, eliciting multiple points of view, and stimulating discussion. Following the formative research, the L&M team will design and cognitively test mock-ups and explanatory language for the HAI measures.  The goal of cognitive testing will be to determine how to best explain and present the new information such that consumers and professionals can draw accurate and useful inferences from the data.  The team will use one-on-one interviews for this part of the research, in order to gain more in-depth, nuanced, and detailed feedback from individuals.  Prior experience suggests that comprehension or interpretation of complex technical information is better probed in one-on-one settings, as the dynamics of focus groups can make it difficult to tease out variations among individuals. Because this study is qualitative, data collection will employ convenience samples of individuals from different social and economic backgrounds and segments of the population, including consumers who have had a recent hospital stay or who anticipate such a stay, caregivers of patients with recent or anticipated hospital experience, and hospital professionals with some knowledge and/or experience with HAIs.  

Results: Research will be completed May – July, 2011.  Results are pending.

Conclusions: The team will present research findings related to the central research questions of interest, including (1) how consumers perceive hospital quality, variations in quality, and indicators of hospital quality; and (2) how consumers and professionals understand and interpret new measures and HAIs as indicators of hospital safety.

Implications for research and/or practice: The research will identify effective approaches as well as particular issues or concerns that should be avoided in the presentation of data on HAIs to the public.