Position paper on the transparency of information related to health care interventions

The Health Quality & Safety Commission has reviewed the evidence surrounding publication of outcomes data such as rates of surgical mortality and other complications. This review includes the practical effects of reporting the outcomes of individual clinicians and those of wider teams.

The Commission supports transparency – ‘shining the light’ – to assure and improve the quality and safety of health care. Feedback to the Commission confirms wide support in New Zealand for this position and the view is widely held in most comparable countries. 

The balance of the positive and negative practical effects of transparency on quality of health care is less clear in the context of the publication of outcomes data (such as surgical mortality and complications rates). In particular, it seems there is an important distinction between reporting information on the performance of individual practitioners and reporting information on the performance of units, organisations or teams.

The following matters need to be considered when thinking about transparency of outcomes data:

1. the views of New Zealand patients and consumers
2. data considerations, appropriateness of measures, and registries
3. the requirements for informed consent (and the autonomy of patients)
4. how best to use data to drive improved outcomes and improve quality of care
5. how outcomes data may contribute to assuring the accountability of practitioners and organisations.

In this paper we summarise the evidence on these issues, and draw conclusions. We reviewed the literature, held a workshop with consumers, and consulted the sector (by seeking responses to a draft paper summarising the literature and the issues). More detail on the search strategy, cited publications, and reviewed submissions is provided in the evidence review and appendices document, available to download below.