How do providers respond to the public disclosure of hospital performance? A realist synthesis

We review the evidence from report cards in the US and UK to understand when, how and why hospital providers respond to performance feedback by taking steps to improve patient care.

Abstract

Publicising hospital performance on a range of quality measures has been adopted as a policy designed to improve patient care in the UK, US and many countries across Europe.  In the UK, this policy has been expressed through the Care Quality Commission’s Ofsted style ratings of hospitals but also more specific indicators such as the National Patient Reported Outcome Measures (PROMs) programme for knee, hip, groin repair and varicose vein surgery.  In this presentation, we explore the underlying ideas and assumptions about how this policy is supposed to work and present some of our initial findings from an NIHR HS&DR funded realist synthesis of PROMs feedback.  We review the evidence from ‘report cards’ in the US and the feedback of patient experience data in the UK to understand when, how and why hospital providers respond to performance feedback by taking steps to improve patient care (and when they do not).

Speaker

Joanne Greenhalgh and Sonia Dalkin

Disclaimer

This study was funded by the National Institute for Health Research (12/136/31).  The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS or the Department of Health.

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