Confidential Physician Feedback Reports: Designing for Optimal Impact on Performance
Confidential feedback reporting is widely considered to be a precursor to and a foundation for performance improvement. However, to enable change, the physician responsible for and capable of change must receive, understand, and act on the information. This guide informs developers of feedback reports about evidence-based strategies to consider when developing or refining a feedback reporting system. This guide is appropriate for many audiences, including medical groups, health plans, payers, professional societies, regional quality improvement collaboratives, and dissemination and implementation campaigns.
Peggy McNamara, Agency for Healthcare Research and Quality Dale Shaller, Shaller Consulting Group Jan De La Mare, Agency for Healthcare Research and Quality Noah Ivers, Women’s College Research Institute and University of Toronto
Part One: Physician Feedback Report Fundamentals
1-1. What are confidential physician feedback reports and what is their purpose?
1-2. Do physician feedback reports work?
1-3. What types of organizations develop confidential physician feedback reports?
Part Two: Design of Physician Feedback Reporting Systems
2-1. Identifying a clinical focus
2-2. Ensuring underlying data support aims of report
2-3. Optimizing user functionality
2-4. Delivering to promote impact
Part Three: Three Strategies for Continuous Improvement of Physician Feedback Reporting Systems
3-1. Systems that enable physicians to correct patient-level data
3-2. Prerelease testing: Giving physicians the opportunity to make feedback reports work for them
3-3. Postrelease monitoring and evaluation
Part Four: A Research Agenda To Advance the Science of Physician Feedback Reporting Systems
4-1. Understanding key attributes of highly successful feedback reporting systems
4-2. Understanding the implementation contexts that promote highly successful feedback reporting systems
4-3. Understanding factors that affect both the design and context of feedback reporting systems
Appendix 1. Advantages of sharing “unblinded” performance data within a team, practice, or network*
Appendix 2. Performance improvement messaging for physicians: lessons from market research*
This guide is a practical resource designed to inform readers, particularly developers of confidential physician feedback reports (e.g., medical groups, health plans, payers, professional societies, regional collaboratives, and dissemination and implementation campaigns), about evidence-based strategies to consider when developing or refining a feedback reporting system.
The findings and conclusions in this document are those of the authors and do not necessarily represent the views of the Agency for Healthcare Research and Quality (AHRQ) or the U.S. Department of Health and Human Services (HHS). Mention of any products, Web sites, or related materials does not imply endorsement by AHRQ, HHS, or the U.S. Government.
Although the authors take sole responsibility for this publication, the clarity and organization of its content benefited greatly from thoughtful comments made by the following individuals who generously contributed their time and expertise in reviewing a formative draft: Jim Chase, Minnesota Community Measurement; Robbie Foy, University of Leeds; Michael Fischer, National Resource Center for Academic Detailing; Irene Fraser, formerly with AHRQ; Janice Genevro, AHRQ; Courtney Gidengil, RAND; Tasneem Khan, University of Leeds; Bruce Landon, Harvard Medical School; Rodney McCurdy, AHRQ; Robert McNellis, AHRQ; and Stephanie Teleki, California HealthCare Foundation. A special thank you is extended to Lynette Lilly, K4 (AHRQ contractor), for her capable and prompt assistance with references.
*This section was excerpted and adapted from a contribution to Shaller D, Kanouse D. Working paper. Private physician feedback reports: a decision guide written by Steven J. Atlas, M.D., M.P.H., Director, Primary Care Research & Quality Improvement Network, and Charlotte Ward, M.P.H., System Innovation Analyst, Primary Care Operations Improvement Program.