1. Describe how nurse sensitive indicators are made publicly available via the Illinois Hospital Report Card Act.
2. Describe the importance of data definition in overcoming difficulties encountered in the administrative rule-making process.

There continues to be a proliferation of interest in open reporting intended to empower consumers by making quality information about hospitals available to the public.  While the goal of placing meaningful information about patient safety and quality measures before the public is admirable, the reality is that these data are challenging to accurately represent in a format that can be utilized by patients to draw conclusions about the quality of care they can expect to receive.

The Illinois Hospital Report Card Act was enacted in August 2003.  It allows Illinois consumers access to information about hospital nurse staffing and patient outcomes.  The measure provides that some staffing and training information will be disclosed by hospitals upon request while additional nursing and nosocomial infection data will be reported quarterly to the public via the state Health Department’s website.  Reportable data include:  annual staff nurse vacancy and turnover rates; nursing hours per patient day; average daily census and average hours worked; select nosocomial infection rates; and risk-adjusted mortality data.  The act also includes whistleblower protections for hospital employees.

The original proposed legislation appeared to impose costly and confusing tracking and administrative burden on hospitals, could potentially lead to publishing invalid mortality and morbidity data, allowed employees to make false accusations against hospitals with impunity and yielded very little meaningful consumer information.  The purpose of this presentation is to describe how a partnership between the state hospital association, nurse executives, and nursing labor unions was effective in ultimately leading to compromise legislation.  However, successful passage of legislation is only the first step.  The significant difficulties encountered in the administrative rule-making process have delayed full implementation of the legislation for more than two years and will be discussed.

This legislation is potentially a landmark change for consumers in this state, and also for hospitals, their medical and nursing staffs, and the Department of Public Health.  Key stakeholders are working together via a data validity and data accuracy protocol so that hospitals’ compliance efforts result in more than merely another data repository activity.  When fully operationalized, the State’s consumers will have access to useful information that reflects patient outcomes within the context of nursing care.