How can the public identify an excellent health-care organization?

You've had these conversations with a friend or relative. "Tell me which is the best hospital[horizontal ellipsis]. or clinic [horizontal ellipsis] or physician [horizontal ellipsis] or place or provider from whom to receive care." Despite being the year 2002, we continue to struggle with available information to make good health care decisions, and some might say that the waters are getting muddier. Differing and inconsistently identified measures of "quality" adds to the confusion. The specter of having some information "out there" but not being to get one's hands on it remains in the minds of many.

Health care organization quality awards are one way that organizations seek to distinguish themselves and demonstrate their excellence. Beyond accreditation, local, regional and national awards of quality recognition seek to demonstrate excellence. Some such awards may require highly prescriptive measures and expectations, along with scientifically based criteria and a sound process for achievement. Others of these awards are much less rigorous in achievement [horizontal ellipsis] with some having criteria that fall into the obtuse or irrelevant category.

Websites of data or standards compliance are an increasingly available information source reflecting health care quality. From employer groups to proprietary organizations, there are growing numbers of those who request/demand health care organizations to share clinical and process data to demonstrate attention to evidence-based guidelines, clinical outcomes, and quality or safety standards. Again, criteria and expected information can vary widely from website to website or group to group. A measure considered relevant one month can change the next on less scientifically oriented sites. Accuracy of data sources comes into question. Validity of use of these data as a public reference, particularly without clarification or context is also challenged.

Any or all these data, reports, or awards can be packaged into advertisements or promotional materials shared by health care organizations, payers, employers, or special interest groups. While access to any information is usually considered important, such promotional materials rarely include sufficient detail on which to make critical judgements. Knee jerk reactions and misinterpretation is a common end result.

We live in a transitional time in this information age [horizontal ellipsis] when we expect data and information to be available and useful, but in reality the science is not yet grown. More data about health care quality is available than ever before, yet less solid, useful information on which to make decisions is clear. True information on quality remains outside our grasp. This transitional time is necessary, however, to progress toward a time when such information can be placed in the hands of the public and care providers, and can be used in a meaningful way.

The science of what and how to disclose data to the public is emerging, but has not yet arrived. And we have yet to begin the most critical part-that is educating the public (and sometimes even us providers) on how to understand and use it for continuous improvement.

-Patricia Schroeder RN, MSN, MBA

Editor