Effect of Modest Pay-for-Performance Financial Incentive on Time-to-Discharge Summary Dictation Among Medical Residents

Abstract

A modest financial incentive resulted in a marked improvement in the time-to-discharge summary dictation by medicine residents. Pay-for-performance programs may be an effective strategy for improving the quality and efficiency of patient care in academic medical centers.

Optimizing the quality of hospital discharge summaries – a systematic review and practical tools

“…Improving the systematic teaching of how to write DS is within the responsibility of the medical schools, specialty training institutions and professional bodies [32,36]. Although interesting and innovative educational ideas, for example, a 'pay for performance' system investigated by Wolk et al or a combination of training, feedback, template and incentive assessed by Bischoff et al should be appreciated and applied in clinical practice, the focus of postgraduate training seems to be simple educational sessions and workshops combined with feedback [24,40].…”

“…A mild incentive increases timeliness remarkably [40]. Reducing the workload, that is, fewer patients per doctors, increased the DS quality.…”

“…Regarding question 1, 19 studies were included in this review [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. The analysis of these articles revealed considerable heterogeneity in the types of intervention and research design.…”

Impact of a financial incentive on the completion of educational metrics

“…This quality improvement bundle was associated with significantly increased order set use. Further studies have demonstrated that clinical financial incentives can be used to manipulate ED length of stay, documentation efficiency, and other care processes [11,12,16,19].…”

“…Performance-based financial incentives are widely used in industry and have demonstrated effectiveness as motivational tools, boosting productivity, and attracting and retaining top talent [9,10]. Performance-based financial incentives are now prevalent in clinical healthcare settings where they have been associated with improved processes of care [11][12][13]. In academic medicine, we have seen the advent of relative value units (RVUs) for educational activities, with the teaching value unit (TVU) and educational value unit (EVU), but their reported use is currently limited [14,15].…”