Of apples and oranges - To whom stroke registry users want to compare themselves to set goals for hospital quality indicators

Background and aims: When provided to relevant stakeholders in appropriate form, feedback of care quality indicators from patient registries can lead to improvements in hospital-provided care quality. Common for design-oriented work, a small-scale qualitative study aimed at providing ideas and justifications for the design of registry feedback by understanding and unpacking needs of users regarding their goal setting of quality indicators (QI), how registry feedback currently supports them, and to what degree those needs aligned with people who instead track data about themselves.

Method: We analysed the feedback from online dashboards and reports provided by the registry of stroke care quality (RES-Q) as a case based on Munzner’s data visualization typology. Along with user needs from the self-tracking literature, we conducted thematically analysed semi-structured interviews with several RES-Q users (hospital and national coordinators, and neurologists) from the European Stroke Organization East (ESO-East).

Results: RES-Q users sought realistic goals for their QIs preferably from hospitals similar to them. International benchmarks or median values of QIs from other countries were considered by some unrealistic and demotivating when those implied or relied on contextual factors such as resources or infrastructure unavailable to them. Examples of contextual factors affecting QI included availability of equipment, specialist training levels, citizen awareness, geographic location, and services provided by emergency vehicles.

Conclusion: To set realistic goals and support learning from peers, registries should support users in comparing themselves to hospitals that share many of their contextual traits but perform better.