One of the Robert Wood Johnson Foundation’s (RWJF) expectations for the Aligning Forces for Quality communities (the Alliances) is the public reporting of standardized measures of patients’ experiences with ambulatory care from the CAHPS Clinician & Group Survey (CG-CAHPS). One way to satisfy this requirement is to take advantage of existing but separate patient surveying efforts in the community and combine the results to produce a community-level public report. This "leveraged approach," which has unique benefits and challenges, requires many decisions along the way to aggregate the results of the CG-CAHPS Survey appropriately for public reporting.

This decision guide offers a detailed discussion of the issues and choices stakeholders typically will face when using the leveraged approach. It is designed to inform leaders of health systems and medical practices in the community and the Alliance staff working with them to support the decision-making process. There are no right and wrong answers, and the best approach for one community may not work for another. While the considerations are similar, each community’s leveraged approach will be different depending on the current survey activities and preferences of stakeholders.

Issues addressed in this guide include:

• Understanding the current survey environment
• What version of the survey to use
• How often to sample patients
• The level at which to collect and report data
• Which populations to survey
• How to administer the survey
• How to prepare data for public reporting
• How these decisions play out in three Alliances

Aligning Forces for Quality (AF4Q) is RWJF’s signature effort to lift the overall quality of health care in targeted communities, as well as reduce racial and ethnic disparities and provide real models for national reform.