Using report cards and dashboards to drive quality improvement: lessons learnt and lessons still to learn

More than 50 years of health services research has driven home a core lesson: unintended and inappropriate variations in care are common.1 2 Identification of such variation in obstetrics was the impetus for Archie Cochrane to start his work.3 In this issue of BMJ Quality & Safety, Weiss and colleagues report an intervention developed to address inappropriate variation in aspects of maternal newborn care across Ontario, Canada's most populous province.4 The intervention involved systematic collection and analysis of administrative data to assess key quality indicators for all hospital births in the province and provision of this data in a 'dashboard' back to hospitals.

Measuring quality of care and comparing this against agreed-upon standards of practice or peer performance (ie, audit) and delivery of the results to healthcare professionals and/or administrators (ie, feedback) is a common quality improvement strategy.5 Whether referred...

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