• Report cards have emerged as a method of measuring and reporting surgical outcomes, and they serve as a stimulus for quality improvement and increased patient safety. The purpose of this rapid response was to summarize recent literature on the use of report cards and outcome measurements to improve the safety of surgical care and ways these can be implemented.
• Our literature search identified thirteen new original research studies that evaluated the effectiveness of surgical report cards in improving outcomes. Nine pre-post or longitudinal study designs as well as four controlled before-and-after studies were included. Five quality collaboratives using surgical report cards and one systematic review were identified. No randomized trials were identified. All studies, with the exception of one, were at moderate or high risk of bias.
• ACS-NSQIP was the most frequently used report card in the included studies, used in seven out of thirteen, not including the studies on collaboratives or the systematic review.
• Of the studies included, pre-post or longitudinal studies, which use report card data to implement quality improvement initiatives, often reported decreases in morbidity and/or mortality. Studies with stronger internal validity tended to show no statistically significant benefits, but 95% confidence intervals were wide and thus clinically important benefits could not be excluded. In these latter studies, links between the report card and the use of a targeted quality improvement intervention are generally not known.
• Few studies addressed the critical aspects of surgical report cards such as implementation of outcomes-based quality improvement programs, sustainability over time, or ways to address barriers and facilitators.

Maggard-Gibbons M, Blegen M, Tupper H, Girgis M, Premji A, Huy T, Motala A, Lawson E, Shekelle PG. Making Healthcare Safer IV: Use of Report Cards and Outcome Measurements To Improve the Safety of Surgical Care. (Prepared by the Southern California Evidence-based Practice Center–RAND Corporation under Contract No. 75Q80120D00003). AHRQ Publication No. 23(24)-EHC019-4. Rockville, MD: Agency for Healthcare Research and Quality. November 2023. https://doi.org/10.23970/AHRQEPC_MHS4REPORTCARD. Posted final reports are located on the Effective Health Care Program search page.