R4: Quality Indicators |CROR| - Rehabilitation Institute of Chicago

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R4:Translating Quality Indicators to Enhance Consumers' Post-Acute Care Choices


Why is this study needed?

Quality indicators such as the Center for Medicare and Medicaid Services’ (CMS) Nursing Home Compare, Commission for the Accreditation of Rehabilitation Facilities’ (CARF) draft Performance Indicators and the Joint Commission's. Quality Check are sources of information consumers can use when deciding about post-acute care providers. Consumers’ use of these and other quality indicators may be limited due to poor health literacy or by a lack of trust in the sources publishing the quality data. Developing more consumer-driven versions of the quality indicators, however, may have unknown ramifications for other key rehabilitation stakeholders.

How will this study help patients and rehabilitation stakeholders?

This study will provide healthcare quality information in ways that are most helpful for consumers when selecting rehabilitation services by understanding how format and presentation style influence patient understanding of rehabilitation quality outcome indicators.

What are the project objectives?

  • Objective 1:
    Explore consumers' and caregivers' decision-making processes when selecting a Post Actue Care (PAC) setting and facility, including the key decision makers, domains of information that guide the decision and the role of available quality indicator data.
  • Objective 2:
    Develop and refine enhanced print versions of PAC quality data that presents comparative quality information in a manner that is comprehensible to consumers and their caregivers regardless of literacy levels.
  • Objective 3:
    Evaluate the efficacy of enhanced print versions of PAC quality indicators to improve consumers; and caregivers' comprehension of the quality indicators, the value they attribute to indicators as a part of the process of selecting a post-acute provider and their intention to use indicators when facing future provider choices as compared to currently available quality indicators.
  • Objective 4:
    Compare consumers' and caregivers' perceptions of sources of PAC quality indicators in terms of trustworthiness and identify variations in trustworthiness across subsets of consumers and caregivers.
  • Objective 5:
    Obtain feedback from other rehabilitation stakeholders on consumer and caregiver preferences for format and source of PAC quality indicators.

How will the project objectives be achieved?

  • Round 1:
    We conducted 30 in-depth interviews with consumers who currently use rehabilitation services in either inpatient rehabilitation or skilled nursing facilities. Respondents will be asked to describe how they selected a PAC setting and provider and if they were aware of the availability of any quality indicator or outcome data. The interview will end with a structured assessment.
  • Round 2:
    A series of cognitive interviews will be conducted to assess the accessibility of the enhanced print materials by low literate adults, what message content is appropriate for the print handout, and to improve the layout and appeal of the revised, enhanced print handout to maximize accessibility among low literate adults.
  • Round 3:
    The final version of the enhanced print version of the PAC quality indicators will be evaluated in a controlled clinical trial among consumers, caregivers, and potential consumers to estimate their efficacy for improving comprehension of quality indicator data.

What agency funded the project?

National Institute of Disability and Rehabilitation Research (NIDRR)

NIDDR Grant Number: H133B040032

What is the duration of the project?

December 01, 2004 - November 30, 2009

Project Staff

Anne Deutsch, Ph.D., Principal Investigator, Rehabilitation Institute of Chicago
Elizabeth Durkin, Ph.D., Co-Principal Investigator, Northwestern University
Michael Wolf, Ph.D., Co-Principal Investigator, Northwestern University
Allen Heinemann, Ph.D., Co-Investigator, Rehabilitation Institute of Chicago

Related Project Research Web Sites

National Institute of Disability and Rehabilitation Research (NIDRR)
National Rehabilitation Information Center (NARIC) 

Contact Information

For researchers and students
Anne Deutsch, Ph.D.

For members of the media