Reporting on QI efforts for internal and external customers.

BACKGROUND: In April 1993 the Methodist Hospital of St Louis Park, Minnesota, released its first internal quality report on outcomes and quality improvement (QI) initiatives. When a local television news reporter mentioned the report in a segment on health care quality, public interest led the hospital to launch an annual series of external quality reports in addition to its internal quality reports. When the eight-page external report was first released in 1994, consumer response was weak, but the report generated a strong response from the mass media, trade publications, the business community, and other health care organizations nationwide. DATA COLLECTION AND USE: Data on sentinel events and outcomes analysis of a variety of clinical and administrative functions have assisted in identifying opportunities for improvement. For example, the hospital monitors the five-year survival rate for patients with myocardial infarction. With the adoption of treatment with streptokinase, data indicated frequent hypotension. Increase of infusion from 30 to 60 minutes led to a decrease in hypotension. THE REPORTS: The external report included, in shorter and simpler form, almost all the sections in the internal report, such as QI activities (teams, training, critical paths), clinical outcome measures, community health, patient satisfaction, value, and accreditation. The indicators included in the external report were selected to minimize potential misinterpretation by public audiences.
CONCLUSIONS: By increasing the visibility of QI within the hospital, the internal quality reports have helped generate further QI activity, and the external report augmented further positive publicity among the local health care press. The reports are proven effective tools for communicating the hospital's ability to sustain and improve the quality of its services over time.