Physician Perceptions of Performance Feedback in a Quality Improvement Activity

Eden, Aimee R.; Hansen, Elizabeth Rose; Hagen, Michael D.; Peterson, Lars E.

doi:10.1177/1062860617738327

Cited by 14 publications

(32 citation statements)

References 32 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, the addition of a measure requires changes to the reports form and content to display new information. Refinements from understanding the user may relate to user preferences or ability to read a type of chart [24] or user expectations for meaningful comparators [25].…”

Section: Refine Measuresmentioning

confidence: 99%

Designing clinical practice feedback reports: three steps illustrated in Veterans Health Affairs long-term care facilities and programs

et al. 2020

View full text Add to dashboard Cite

Background: User-centered design (UCD) methods are well-established techniques for creating useful artifacts, but few studies illustrate their application to clinical feedback reports. When used as an implementation strategy, the content of feedback reports depends on a foundational audit process involving performance measures and data, but these important relationships have not been adequately described. Better guidance on UCD methods for designing feedback reports is needed. Our objective is to describe the feedback report design method for refining the content of prototype reports. Methods: We propose a three-step feedback report design method (refinement of measures, data, and display). The three steps follow dependencies such that refinement of measures can require changes to data, which in turn may require changes to the display. We believe this method can be used effectively with a broad range of UCD techniques. Results: We illustrate the three-step method as used in implementation of goals of care conversations in long-term care settings in the U.S. Veterans Health Administration. Using iterative usability testing, feedback report content evolved over cycles of the three steps. Following the steps in the proposed method through 12 iterations with 13 participants, we improved the usability of the feedback reports. Conclusions: UCD methods can improve feedback report content through an iterative process. When designing feedback reports, refining measures, data, and display may enable report designers to improve the user centeredness of feedback reports.

show abstract

Section: Refine Measuresmentioning

confidence: 99%

Designing clinical practice feedback reports: three steps illustrated in Veterans Health Affairs long-term care facilities and programs

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Several studies have shown that the comparison with peers has a positive effect on behavioral change [4][5][6][7][8]. Whether regression towards the mean of peers is good, however, depends on the excellence of the peers' practice, which may not always be taken for granted.…”

Section: Limitationsmentioning

confidence: 99%

“…The feedback that compares the performance of clinicians with their peers is even more important for the behavioral change of clinicians [4][5][6][7][8]. Meeker et al [5] found peer comparison to be the most efficient feedback method to minimize inappropriate antibiotic prescriptions.…”

Section: Introductionmentioning

confidence: 99%

“…Meeker et al [5] found peer comparison to be the most efficient feedback method to minimize inappropriate antibiotic prescriptions. A large study on the perception of feedback on clinical performance by physicians revealed the importance of peer comparisons with similar patient populations and practice characteristics [6]. Continuous feedback is necessary for sustaining the achieved gains after improvement takes place [4,9,10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Privacy-preserving architecture for providing feedback to clinicians on their clinical performance

Yigzaw

Budrionis

Marco-Ruiz

et al. 2020

BMC Med Inform Decis Mak

View full text Add to dashboard Cite

Background: Learning from routine healthcare data is important for the improvement of the quality of care. Providing feedback on clinicians' performance in comparison to their peers has been shown to be more efficient for quality improvements. However, the current methods for providing feedback do not fully address the privacy concerns of stakeholders. Methods: The paper proposes a distributed architecture for providing feedback to clinicians on their clinical performances while protecting their privacy. The indicators for the clinical performance of a clinician are computed within a healthcare institution based on pseudonymized data extracted from the electronic health record (EHR) system. Group-level indicators of clinicians across healthcare institutions are computed using privacy-preserving distributed data-mining techniques. A clinician receives feedback reports that compare his or her personal indicators with the aggregated indicators of the individual's peers. Indicators aggregated across different geographical levels are the basis for monitoring changes in the quality of care. The architecture feasibility was practically evaluated in three general practitioner (GP) offices in Norway that consist of about 20,245 patients. The architecture was applied for providing feedback reports to 21 GPs on their antibiotic prescriptions for selected respiratory tract infections (RTIs). Each GP received one feedback report that covered antibiotic prescriptions between 2015 and 2018, stratified yearly. We assessed the privacy protection and computation time of the architecture. Results: Our evaluation indicates that the proposed architecture is feasible for practical use and protects the privacy of the patients, clinicians, and healthcare institutions. The architecture also maintains the physical access control of healthcare institutions over the patient data. We sent a single feedback report to each of the 21 GPs. A total of 14,396 cases were diagnosed with the selected RTIs during the study period across the institutions. Of these cases, 2924 (20.3%) were treated with antibiotics, where 40.8% (1194) of the antibiotic prescriptions were narrowspectrum antibiotics.

show abstract

“…The study team conducted a study across a wide range of innovation models to learn what approaches have worked well to provide claims-based data to model participants and what could be improved going forward. Prior literature addressing confidential feedback data have tended to focus on reporting to physicians, [5][6][7][8][9][10][11] especially primary care physicians, [8][9][10][11] and, more recently, accountable care organizations (ACOs). 11,12 This study makes an important contribution by evaluating the provision of claims-based data to a much broader range of organizations participating in 18 CMS models.…”

mentioning

confidence: 99%

Lessons Learned in Providing Claims-Based Data to Participants in Health Care Innovation Models

Cohen¹,

Irie²,

Russo³

et al. 2018

Am J Med Qual

View full text Add to dashboard Cite

The Centers for Medicare & Medicaid Services (CMS) has been providing data to organizations participating in a range of innovation models to help them implement interventions and to provide feedback on performance. The authors studied 18 CMS models to gain a better understanding of factors contributing to model participants' use or nonuse of CMS-provided data. Factors that contribute to greater use include providing data that participants view as actionable, some type of accountability for performance, robust learning support, participants having resources to work with the data, and soliciting ongoing feedback about the data and related learning needs. Factors that discourage data uptake include time lag, lack of aggregated multi-payer data, exclusion of data for sensitive diagnoses, and small sample sizes. Claims-based data from payers can be an important source of information to innovation model participants. Lessons from this study can increase the usefulness of such data.

show abstract

Physician Perceptions of Performance Feedback in a Quality Improvement Activity

Cited by 14 publications

References 32 publications

Designing clinical practice feedback reports: three steps illustrated in Veterans Health Affairs long-term care facilities and programs

Designing clinical practice feedback reports: three steps illustrated in Veterans Health Affairs long-term care facilities and programs

Privacy-preserving architecture for providing feedback to clinicians on their clinical performance

Lessons Learned in Providing Claims-Based Data to Participants in Health Care Innovation Models

Contact Info

Product

Resources

About