Surgeon’s experiences of receiving peer benchmarked feedback using patient-reported outcome measures: a qualitative study

Abstract

BackgroundThe use of patient-reported outcome measures (PROMs) to provide healthcare professionals with peer benchmarked feedback is growing. However, there is little evidence on the opinions of professionals on the value of this information in practice. The purpose of this research is to explore surgeon’s experiences of receiving peer benchmarked PROMs feedback and to examine whether this information led to changes in their practice.MethodsThis qualitative research employed a Framework approach. Semi-structured interviews were undertaken with surgeons who received peer benchmarked PROMs feedback. The participants included eleven consultant orthopaedic surgeons in the Republic of Ireland.ResultsFive themes were identified: conceptual, methodological, practical, attitudinal, and impact. A typology was developed based on the attitudinal and impact themes from which three distinct groups emerged. ‘Advocates’ had positive attitudes towards PROMs and confirmed that the information promoted a self-reflective process. ‘Converts’ were uncertain about the value of PROMs, which reduced their inclination to use the data. ‘Sceptics’ had negative attitudes towards PROMs and claimed that the information had no impact on their behaviour. The conceptual, methodological and practical factors were linked to the typology.ConclusionSurgeons had mixed opinions on the value of peer benchmarked PROMs data. Many appreciated the feedback as it reassured them that their practice was similar to their peers. However, PROMs information alone was considered insufficient to help identify opportunities for quality improvements. The reasons for the observed reluctance of participants to embrace PROMs can be categorised into conceptual, methodological, and practical factors. Policy makers and researchers need to increase professionals’ awareness of the numerous purposes and benefits of using PROMs, challenge the current methods to measure performance using PROMs, and reduce the burden of data collection and information dissemination on routine practice.

Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of patient-reported outcome measures data to improve patient care

“…In our review, we found that clinicians remained sceptical about the validity of PROMs data for a number of reasons, including their reliance on patients' subjective reports and the process of case-mix adjustment. 97,194 GPs were also not convinced that patient experience data reflected what they considered to be 'good care.' 223 Indeed, recent evidence indicates that following good practice in terms of antibiotics prescribing may reduce patient satisfaction.…”

“…However, providers may question if the subjective reports of patients can serve as reliable indicators of their health outcomes, and some have expressed concerns that patients' ratings of their outcomes may be unduly influenced by their experiences. 97,194,223 The underlying assumption of all of these claims is that it is the data and what is done to the data (i.e. case-mix adjustment) that providers object to.…”

“…97,195,224 Both the source of performance data and the process through which they are collected and presented are important influences on whether or not such data are perceived as credible by clinicians. We also found support for the theory that clinicians perceived data from patients' notes as being more credible than performance data derived from administrative data.…”

Feedback preferences of patients, professionals and health insurers in integrated head and neck cancer care

“…Other literature is focussed mainly on preferences of patients or clinicians, but this study includes preferences of four different stakeholders. 22,36,37 It is also directed towards different types of indicators, namely process, structure and outcome indicators. Furthermore, it…”

Designing Emails Aimed at Increasing Family Physicians� Use of a Web-Based Audit and Feedback Tool to Improve Cancer Screening Rates: Cocreation Process (Preprint)

“…However, audit and feedback tools can only be effective if physicians access them to review their clinical performance data. Physicians who do not see their performance feedback data are not likely to use it for quality improvement [2]. Thus, there is a need to understand how to promote access to, and ultimately use of, audit and feedback tools among physicians.…”