In many settings, public reporting of health care outcomes still reflects the "name-shame-blame" culture that has permeated large areas of the health care sector for decades. A new approach to public reporting in Queensland, based on statistical process control, emphasises the dynamic nature of performance against specified outcome measures by focusing on the actions that hospitals are taking if their indicators vary from the average. The aim is for public reporting to contribute to, rather than detract from, the creation of an internal culture that emphasises rigorous investigation and improvement rather than merely assigning blame for problems.