Appendix C: Summary of Write-in Survey Responses by Respondent Type (continued 3)

Users of Public Reports of Hospital Quality: Who, What, Why, and How?

Health Care Professional Respondents

4) What was the primary purpose of your visit to the Web site today? To:

Purpose	All Web Sites
	n=320
	Count	%
Compare my hospital's performance to other hospitals' performance	88	27.5%
See how my hospital is performing	54	16.9%
Get practical information about a hospital	16	5.0%
Choose a hospital to make a patient referral	14	4.4%
Choose a hospital for myself	8	2.5%
Quality improvement	8	2.5%
General interest in Web site content	22	6.9%
Academic	12	3.8%
Other	51	15.9%
Missing	47	14.7%

The "Other" category in the table includes the following answers from respondents:

#	Text Entered
1	Check the newest news release
2	Compare all [STATE] hospitals' performance
3	Compare clinics
4	Evaluate how our clinics compare to others
5	FIND A DOCTOR
6	Inpt and outpt correction
7	Interested in How [HEALTH PLAN] stacks up
8	Look at a hospital's historical performance
9	Metro Scores
10	New grad RN and looking for information
11	Order prescription medication
12	Physician information
13	Read newsletter
14	Review state wide trends
15	Seeking information on data tracking regarding breastfeeding support in patient and out patient
16	To see how [STATE] is handling its mandatory hospital adverse event reporting.
17	Watching the hand washing video and I thought it was very entertaining but the truth is you got the message across in a very creative way and that is great
18	Access reports
19	Background info re: [PROGRAM]
20	Check out hospital standing
21	Check physicians care record
22	Clinical performance data
23	Compare costs of acute care vs LTC facilities
24	Compare performance for clinics
25	Employment
26	Employment
27	Find a contact for the secure Web site
28	Find data for pulmonary rehabilitation
29	Get additional info about [PROGRAM]
30	Get historic ASC data
31	Get statewide statistics on prevalence
32	Health insurance
33	Healthy incentives activity for my health care plan
34	Info on cost
35	Job search
36	Look at the new report
37	Looking for specific hosp data
38	Medical group
39	Peds population data for providers
40	Pick up data
41	Public health information
42	Read article
43	Researching UB-04 requirements
44	Review new report on hospital infections
45	See how my practice is performing
46	See if I am listed—NOT
47	See performance of my primary care physician
48	See progress on challenge overall
49	Seeking policy recommendations
50	To read the article
51	View Primary Care report

6) Did you have other reasons (in addition to the primary reason above) for your visit today? To:

Reasons	All Web Sites
	n=320
	Count	%
See how my hospital is performing	59	18.4%
Compare my hospital's performance to other hospitals' performance	65	20.3%
Choose a hospital to make a patient referral	9	2.8%
Choose a hospital for myself	9	2.8%
Get practical information about a hospital (phone number, location)	11	3.4%
No, I had no other reason	119	37.2%
Other	40	12.5%
Missing	52	16.3%

The "Other" category in the table includes the following answers from respondents:

#	Text Entered
1	Job search
2	Research
3	Get information about quality of care
4	Nurse to patient ratio
5	Find a neurosurgeon
6	Request to take survey
7	Compare 2 SNFs my mother had been in
8	Listed as reference in journal article
9	Validate data against other sources
10	Learn more about your organization
11	Check out Web site
12	Find out more about info offered at your Web site
13	Sometimes I am looking at medical group performance not just hospital
14	School assignment
15	Browse the report
16	See what the Web site looked like and what it offered
17	Health care economic course
18	Thoughtfully consider how to present this kind of information to our region
19	Learn about the program and data
20	I was evaluating clinics, but all the options list hospital
21	Classroom research
22	See if data has been updated to 2010
23	Check on breastfeeding rates
24	Employment
25	Compare regional practices
26	See other above.
27	FIND A DOCTOR
28	Request special data run
29	Register for Mailing List
30	Review what measures are publicly reported
31	Job hunting
32	Looked for comparative info on primary doctors
33	See what all was on the Web site
34	Data mining
35	Determine if this organization would support breastfeeding initiatives as cost savings in health carE
36	Upcoming surgery
37	Check weather site
38	Research Paper
39	Retrieve data
40	Become more familiar with site to teach others

7) What additional information would make the Web site more useful? More information about:

Additional Information	All Web Sites
	n=320
	Count	%
Quality measures that are not currently included	78	24.4%
Quality by inpatient service (for example, intensive care unit, pediatric unit)	63	19.7%
Costs for patients (for example, cost of a procedure, cost of a hospital stay)	87	27.2%
Methodology used to calculate performance measures (for example, risk adjustment methods)	78	24.4%
Detailed results for each hospital (for example, sample size or 95% confidence intervals around their performance)	78	24.4%
Hospitals that are not currently on the Web site	33	10.3%
Individual doctors within a hospital	55	17.2%
Other	36	11.3%
Missing	110	34.4%

The "Other" category in the table includes the following answers from respondents:

#	Text Entered
1	Average Payment Information
2	Data by payer category
3	Data ranges for data
4	Payment info, not charges
5	General epidemiology and health research questions
6	More current data; faster turnaround; help from someone experienced in coding and hospital procedures relating to coding and chargemaster use; I feel like I'm in an endless struggle to clean up my UB data; also something that may be helpful to the public would be a link to other Web sites, i.e. [WEB SITE] and an explanation as to how the [AGENCY] data releases can complement other data sources...just a thought
7	Recommendations for policy
8	Cost for cash patient
9	More than one technical grouping at a time
10	Individual primary care doctors
11	Ability to compare more hospitals at one time
12	More current information! Two year old data is just not acceptable in this era.
13	Accurate c-section rates
14	First time visit, very easy to navigate
15	Ambulatory performance measures
16	Actual rates for SSIs
17	Update information monthly
18	Methods for translating this information to a board
19	What is there is good, more specific to what dates of service or what months the actual scores posted are for! site is hard to use and to understand data, should be easier to understand the data and easier to retrieve
20	Compare hospitals side by side
21	Individual advanced practitioners
22	Slow
23	More current data
24	Perhaps I missed it. However, some sort of "risk adjustment" would be helpful. When a hospital has a small number of adverse events in the midst of literally thousands of procedures there needs to be some "perspective" on what those adverse events really mean.
25	n/a
26	Online version for making special data requests
27	County data only
28	Surgery Centers (Free standing like [FACILITY])
29	Staff satisfaction
30	Missing clinics & individual doctors
31	Comparison to national and state level health indicators to show if these metrics are improving health outcomes associated with increased health care costs.
32	PRIMARY & REPEAT CESAREAN RATES
33	More obvious information for professionals versus lay people
34	Include smaller groups
35	Date of information
36	Pediatric ambulatory info

8) What would make the Web site easier for you to use?

Suggested Improvments	All Web Sites
	n=320
	Count	%
Provide a different way of searching the Web site	31	9.7%
Provide a different way of sorting the results on the Web site	44	13.8%
Make the information easier to understand (for example, less technical terms)	22	6.9%
Make it easier to find the best hospital	32	10.0%
Require fewer clicks to get information that I want	52	16.3%
Other	35	10.9%
Missing	171	53.4%

The "Other" category in the table includes the following answers from respondents:

#	Text Entered
1	Permit query tools like data cubes
2	Most recent report based on search engine listing
3	Make it easier to graph results on the site
4	Need to browse before I can comment
5	Be able to review entire nation results vs just by state
6	Multiple access options
7	No recommendations
8	Why are efficiency ratings set up differently between facilities?
9	Nothing
10	Give explanations for data
11	Updates More Current
12	Comparison of like facilities in size
13	Larger sample more than 5
14	Home page too busy
15	Single hospital data
16	See below
17	I am a little concerned about your choice "make it easier to find the best hospital." Is the best hospital one that has no adverse events, but never took the risk to care for the most ill and fragile patients? Or, the hospital that has taken on the most difficult case and has, as a result, had some "adverse" events?
18	Nothing
19	Include most current data
20	I couldn't easily see how to go straight to your reports
21	Instructions
22	Nothing
23	Icons for all reports in grid on home page.
24	Have hospital vs doctor tab stand out more
25	Graph where you can see multiple hospitals and multiple results all on one page
26	n/a
27	I always cannot get side by side comparisons, every time I am on the site, I can't get to compare several hospitals side by side
28	Compare to 3 other hospitals/facilties
29	Higher number of hospitals being compared
30	Increase run time.
31	Bigger print
32	Nothing
33	Search hospital by area/county
34	It was easy
35	I found it very easy to navigate

9) Please use this box to write any details about what would make this Web site more useful or easier for you to use.

#	Text Entered
1	Average patients do not understand medical terminology. Also, average patients have limited computer access or knowledge of how to navigate through various screens and drop down menus.
2	Purely informational on how the site was set up and changes since the last time I looked
3	Post open heart clinical data collection for 1/1/2011 discharges
4	As a quality professional, I was interested in how to quickly see your graphical reports and thresholds
5	Make it easier to get more than grouping at a time
6	Very easy to use. Just didn't have the data I was looking for
7	I am doing some health care policy research, so I am not the typical user.
8	If the info on individual hospitals is on this site, I did not find it. What I found was aggregate info in the 2009 report on HAIs.
9	I think the Web site is excellent!
10	No suggestions. I thought the search function was easy to use.
11	Needed most recent costs of HO-MRSA infections—was hoping to find latest data first in listing. Needed to search a little further. However, you site is easy to use and I appreciate the information provided.
12	If you do not have policy, and don't plan to have policy, then your search feature works quite well, I did not waste time looking for something that wasn't there
13	I would prefer to see hospitals rank ordered according to outcomes/quality measures per procedure—and looking a comparative data that is 2 years old does not help people make decisions today. Hospitals that were very good could have deteriorated, and hospitals that have made progress in improving quality do not get credit.
14	Would like all states as an option. when will next quarter be released—thru 6/10 available on [WEB SITE]
15	The Web site contains a wealth of information which is helpful. As a health care professional I understand much of what is on the Web site. Some information my be difficult for certain socio-economic groups to understand. The Web site does an excellent job of presenting comprehensive information on managing health.
16	I am a new user and found myself going back to the main page to try to find info I wanted.
17	Would be nice if there was an option to see all measures in the measure set i.e. all the Heart Failur Measures. Clicking in and out of each measure wastes time.
18	The sorting feature is VERY useful (please keep)—although it didn't function correctly once. Take out extraneous info (like IOM aim and the word "measure"). Add an overall summary score or rating for all diabetes or heart care.
19	Include [FACILITY]
20	No PDF for the most recent report a lsit fo the procedures is ridiculous. I will go to the Web site again—I have to, but it is quite disappointing
21	Do comparison of like hospitals, e.g., CAH facilities bench marked.
22	Less clicks are always better for people when looking for the information they want.
23	The printing function doesn't work well—not all pages print, missing images. Make it easy to print out in color for dissemination to staff.
24	Costs could be average for procedures done. Verbage for non-medical people viewing this sight might be considered so that they can understand what they're reading. Always better to have fewer clicks.
25	I have made my comments in the "other" boxes.
26	Allow users to download the data as an excel or csv file. Provide details of when the data was collected (for what dates of service) as well as the source: CMS, HCUP, MHA, etc.
27	You might want to include "eye" providers, both Optometry and Ophthalmology in this area, who actually do the dilated eye exams.
28	I'd like a way to make it easier for me to copy and paste our facilities' data into ppt for internal use.
29	This can be confusing and frustrating as the updates are potentially two rate years old.
30	Will use site because it is important to use.... explanation of the percentage listed what is it for customer service/patient experience what dates of service are posted...so hard to find. and get what you want on the screen
31	Have been taking [STATE AGENCY] data and comparing.
32	Data on charges is irrelevant for most consumers and is not a valuable basis for comparison. Information about average payments would be more realistic and give users accurate insight to financial matters. The home page is dizzying.
33	No info on hip surgery outcomes by physician
34	I know you don't get payment info, but it is more meaningful than charges even though many patients don't know that. Having risk adjustment included would also be nice, but is a big complication. anything that helps educate patients is a plus as well.
35	To be able to compare hospitals on the same screen.
36	N/A
37	I WOULD LIKE TO SEE INFORMATION RE: PRIMARY & REPEAT CESAREANS. ALSO WHETHER A HOSPITAL IS APPLYING FOR OR HAS BABY-FRIENDLY STATUS (CONFERRED BY THE WORLD HEALTH ORG.)
38	Performance based on a service line instead of specific disease measure would be very helpful.
39	Would like to see broader list of medical treatments / measures reported.
40	With many of these hospitals being so small, how does the user know whether the sample size was large enough for the data to be pertinent? Also, the below-as expected-above ratings are not very helpful. It only allows for limited comparison.
41	I think risk adjustment and payment/cost information is very important; risk is a tough concept to explain to consumers/patients, but I think it would be helpful to add something like this to help insure the comparison is apples to apples.
42	List VAP, Central line blood stream infection, foley catheter related infection
43	Data was out of date.
44	Is this site designed for professionals or patients
45	I view this Web site a lot as part of my job
46	I like the Web site and it had great information. I was looking for more of an exact number for nurse to patient ratio. I wanted to be able to compare our hospial med surg unit to other better performing hospitals to see if there was a big difference.
47	It took me a while to find out which areas were covered by the regions, but eventually I found the answer
48	Allow a full menu of facilities rather than asking us to put in hospital name. Had difficult time locating [FACILITY]
49	At the bottom of the pages listing all of the hospitals have an alpha search rather than a page number search
50	I was using [WEB SITE] and was having difficulty sorting data just by state and outcomes. I ultimately figured it out but I think most people would give up instead of spending the time to learn it. There may be a better way to sort data.
51	If the number of service cases were broken into principal diagnosis
52	I did not understand who the PPO's were that were named in general terms...was that their name? I'd not heard of them
53	I understood how to use the site intuitively but others with less computer experience, i.e.—older adults, may have more difficulty.
54	Q1 2010 was not included in consumer assessment data, even though it is available on national site. [STATE] Web site is much easier to use than national, so I prefer going here if the data is up to date.
55	I was looking for statewide prevalence data for a procedure: craniectomy for a project I am working on. The addition of epidemiological information, prevalence rates of disease, counts and prevalence of procedures, etc would be of great interest to the commercial world and would be a trivial dataset to produce.
56	Seems like a lot of out dated information. Should be updated more often.
57	In the past, on the patient satisfaction report, you had an indicator on each rated area which showed where the top ten percent scored nationally. It would be nice to have that indicator returned so that we could tell if a [STATE] hospital was in the top ten percent nationally in any rated area.
58	Great Web site, I found it very easy to use. Thank you.
59	The c-section rates specified here are preposterously low. In the birth community, we have heard that the c-section rate at [HOSPITAL] is now over 50%, yet it's specified at 22%, below the national average. The other hospitals have even lower c-section rates. It's hard to believe these aren't grossly inaccurate.
60	Wanted some additional information re staff satisfaction
61	Misleading comparisons do nothing to help the general public choose the best hospital.
62	Easy to navigate
63	Very useful as is
64	I would like to know the benchmarks that cause a Below Average or Above Average rating.

11) Are you a:

Response	All Web Sites
	n=320
	Count	%
Physician	34	10.6%
Nurse practitioner	17	5.3%
Nurse	40	12.5%
Executive	52	16.3%
Quality manager	52	16.3%
Administration	20	6.3%
Other	40	12.5%
Missing	72	22.5%

The "Other" category in the table includes the following answers from respondents:

#	Text Entered
1	Allied health
2	Analyst
3	Analyst
4	Auditor
5	Birth doula
6	CHILDBIRTH EDUCATOR
7	CLS
8	Consultant
9	Consumer Advocate
10	Evaluator
11	IT
12	IT Analyst
13	LACTATION CONSULTANT
14	Midwife
15	Pharmacist
16	Pharmacist
17	Public Relations.
18	RHIT
19	Researcher
20	Respiratory Care Director
21	SURGICAL TECHNOLOGY STUDENT
22	Abstractor
23	Clerical
24	Consultant
25	Data collections
26	Denial management
27	Dietitian
28	Health policy researcher
29	Healthcare advocate
30	Healthcare consultant
31	Healthcare consultant
32	Lab tech
33	Paramedic volunteer
34	Public health professional
35	Social worker
36	Social worker
37	Staff educator
38	Statistical analyst
39	Student @[UNIVERSITY] RN-BSN
40	Volunteer, bereavement and chaplain dir

12) What is your specialty?

Specialty	All Web Sites
	n=51
	Count	%
Internal medicine	15	29.4%
Family Medicine/General Practice	12	23.5%
Pediatrics	2	3.9%
Surgery	6	11.8%
Psychiatry	0	0.0%
Obstetrics/Gynecology	2	3.9%
Other	13	25.5%
Missing	1	2.0%

The "Other" category in the table includes the following answers from respondents:

#	Text Entered
1	Acupuncture
2	CHN
3	Emergency
4	Emergency
5	Oncology
6	Oncology
7	Optometry
8	Public Health
9	Anesthesia
10	Dermatology
11	Heme-onc
12	Other
13	Podiatist

Page last reviewed December 2011

Internet Citation: Appendix C: Summary of Write-in Survey Responses by Respondent Type (continued 3): Users of Public Reports of Hospital Quality: Who, What, Why, and How?. December 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/professionals/quality-patient-safety/quality-resources/value/pubreportusers/pubusersapc3.html