Is My Hospital Safe?: Plain Language and the Power of Data to Spark Action at National, State and Local Levels

Background:  CDC releases a yearly report detailing technical data from CDC's National Healthcare Safety Network, the nation’s most widely used healthcare-associated infection (HAI) tracking system. Each year, the report updates describing HAI prevention improvement at the national, state and local level. In previous years, the report consisted of scientific tables with complicated data. After the 2013 release, the Division of Healthcare Quality Promotion (DHQP) received strong feedback from patient advocates and other partners that the report was too difficult to understand and not reaching appropriate audiences.

Program background:  In 2014, a multidisciplinary team of scientific, communications, policy, and public health staff teamed up to redesign this report to make more accessible. CDC developed a strategy to garner feedback from states, patient advocates, and hospital associations along the way. The team engaged CDC graphics experts to develop a new design. The new format included 52 customized one-pagers (50 states, Washington, D.C., and Puerto Rico); a national snapshot; a Consumer Reports-like composite page demonstrating success; and plain language summaries. The state pages included data descriptions and state actions to prevent hospital infections. CDC had not previously worked with many of these groups on this report.

Evaluation Methods and Results:  Once an initial concept was in place, DHQP staff held conference calls with stakeholders to preview and get feedback to refine the report. At least five calls were held with partners: Patient advocates from Consumers Union, Consumer Reports, and national individual patient advocates; four hospital associations; and state health department staff. The report redesign was launched March 2014. Later that year, the CDC team reassessed the report. Feedback received after the March release were considered and implemented in the 2015 design. DHQP staff continued to partner with stakeholders. This included calls, working closely with state HAI coordinators, and hosting a dedicated conference session at CSTE to review drafts and encourage feedback. The January 2015 report was even more graphic-driven. The state pages show data from different perspectives, the composite page offers more details, and the report contains a glossary. The website-only Q&A was updated for plain language. Patient advocates and hospitals associations have provided positive feedback regarding the report’s plain language, graphic design, and effort taken to reach broader audiences. The January 2015 report was highlighted by the Director of Consumers Union’s Safe Patient Project in a press release, stating “the CDC report is presented in a consumer-friendly manner that allows the public to quickly see where improvements are being made” and “clear explanations and graphics help to make the information understandable.”

Conclusions:  Eliminating HAIs requires a team approach. A policy of transparency and accountability and a reputation as an organization that acts on patients' concerns and health departments’ feedback can go a long way towards gaining and maintaining trust.

Implications for research and/or practice:  Initiating conversations and obtaining feedback from CDC epidemiologists and partners to translate HAI data is not easy. However, this has been a successful way to bring national attention to an ongoing public health issue, provide accessible data for action, and help communicate prevention efforts to address the problem.