Eliciting patient and caregiver perspectives to improve the public reporting of rehabilitation quality measures

Purpose: To evaluate patients' and caregivers' abilities to comprehend information on rehabilitation quality measures, and select high-quality rehabilitation facility. Design: We used exploratory, qualitative study using cognitive interviewing. Setting: Three Outpatient rehabilitation facilities in metropolitan Chicago, Illinois, USA. Participants: The study participants included 27 patients or three caregivers, 63% female; 36.7% white, 43.3% African American, 10% Asian, 10% missing/other; health literacy: 59% at the 8th grade level or lower; age range: 33-94. Main Outcome Measure(s): Patient and caregiver comprehension of quality measures. Results: Respondents understood some rehabilitation quality terms, but had difficulty with medical terminology; linking quality measures to hospital quality; explaining choice of "better" quality facility; and reading tables. The research team simplified terminology, definitions, layout, and design; added an introduction to provide a framework for understanding quality. Conclusions: Quality measure information can be difficult to understand and use. When reporting quality measures, use plain language, avoid medical jargon, follow logically sequenced content, easy-to-read layout, provide framework for understanding quality, and solicit consumer feedback.