THE VALUE OF DATA TRANSPARENCY AT THE POINT OF CARE

Purpose: We examined how sharing process, system performance and patient outcome measures with patients at the point of care impacted patient and family engagement, patient and staff attitudes, and quality, safety and experience outcomes.

Method: We embedded an interactive module using the GetWellNetwork interactive system embedded in patients' in room televisions. Patients from five inpatient units across two hospitals in our Health System (postpartum, surgery, heart/vascular, medicine, ICU Stepdown) were invited once daily to review  a module presenting hand-hygiene, patient falls, pressure ulcers (or breastfeeding for postpartum patients), pain management, and seven-day readmit metrics along with actionable strategies for improving each metric. The module concluded with a six-question survey measuring patient engagement and opinions related to data transparency. We surveyed staff three weeks after the module launched to determine attitudes and perceptions related to the initiative.

Result: In the two units with the largest number of patient participants (postpartum and medicine), the response rates for unique patients were 9.5% (39/407) and 13.1% (30/229).. The surgery, heart/vascular, and ICU stepdown units had response rates of 8.2% (17/208), 11.4% (21/184) and 16.5% (21/127), all during a one month period.

Results from the patient survey at the end of the module appear in Figure 1.

Staff attitudes toward sharing unit level quality and safety data were positive with 61% (11/18) feeling it is a good idea, and 78% (14/18) seeing the GetWellNetwork as an effective delivery system. 89% (16/18) believe that patients deserve to know unit performance metrics for safety and quality accompanied by 94% (17/18) who feel that increased patient involvement will improve outcomes. Impact on patient outcomes were assessed for the two units (postpartum and medicine) with the highest patient response rates. Significant improvement in hand hygiene rates (p=0.001 and p=0.01) and reduction in falls (p=0.02 and p=0.01) occurred while the module was live, while pressure ulcer rates, pain scores, readmission rates and breast feeding rates were unaffected.

Conclusion: Patients and staff have strong positive attitudes toward quality and safety data transparency. While only hand hygiene and fall rates improved, patients appear to be interested in the information and intend to change their behavior, including asking additional questions of their care team. More impact on outcomes may be seen with larger sample sizes and longer follow-up.