Applying continuous improvement in public reporting: What should government reports do for quality improvement?

摘要

Purpose - This paper aims to describe the history and growth of mandatory public reporting ofrnhealthcare-associated infection rates and the philosophy and implementation of an evidence-basedrntotal-quality-oriented state government program and also to provide critical appraisal of recognizedrnassumptions underlying this movement.rnDesign/methodology/approach - This paper provides a narrative review of pertinent evaluationrnresearch literature and the authors' own experience.rnFindings - Washington is one of few states that hired experts in the subject area to develop its newrnprogram. It is one of the first exploring optimal ways to validate the rates reported, and one of very fewrntaking evidence-based approaches to all aspects of program design.rnPractical implications - The work provides a model for less-developed agencies to follow.rnOriginality/value - This is a new and unprecedented role for state health departments, but offersrnopportunities to raise standards of practice through continuous quality improvement approaches withrnhospital partners while regaining public trust through transparency. Weak evidence supportingrnfundamental assumptions, and failure of prior approaches, indicate that we must explore new pathsrnrather than follow established ones.