A Novel Approach to Practice-Based Learning and Improvement Using a Web-Based Audit and Feedback Module

Abstract

Resident quality improvement (QI) involvement fulfills practice-based learning and improvement requirements and develops skills for future practice analysis.1 Several articles have identified programs that have involved residents in QI projects.2-5 Frequently cited challenges include facilitating faculty time, training, or funding; multiple competing educational and clinical demands; and voluntary participation of only a subset of residents. 6,7 Electronic health record limitations in aggregating data and providing performance reports may also limit effectiveness.Few large residency programs (those with more than 40 residents) have published results of QI efforts engaging all The authors would like to thank the second-and third-year residents in the internal medicine residency program at Duke University for their participation. Ambulatory leadership, including the 3 clinic medical directors and the Ambulatory Care Leadership Track, were also instrumental in development and implementation. The medicine residency program office, including Lauren Dincher and Shawna Alkon, are also recognized for their contributions to this project's success. Lastly, we extend gratitude toward the Department of Medicine leadership, including Dr Mary Klotman and Joe Doty, for supporting the development of the tool.

Systematic review and narrative synthesis of computerized audit and feedback systems in healthcare

“…Systems that provided immediately updated or “near real-time” feedback resulted in higher engagement and were more likely to report successful outcomes. 21 , 22 , 24 , 26 , 27 , 31 , 33 , 39 , 41 , 44 , 52 , 55 , 57 , 66 , 70 , 71 , 74–77 , 79–83 , 86–88 , 90–92 , 94 , 97 , 102 , 105–107 The timeliness of feedback enabled the data to be viewed as more credible and representative of performance. 21 , 22 , 24 , 26 , 27 , 31 , 33 , 39 , 41 , 44 , 52 , 55 , 57 , 58 , 66 , 70 , 71 , 75 , 76 , 80 , 82 , 83 , 86–88 , 90–92 , 94 , 97 , 101 , …”

“… 21 , 22 , 24 , 26 , 27 , 31 , 33 , 39 , 41 , 44 , 52 , 55 , 57 , 66 , 70 , 71 , 74–77 , 79–83 , 86–88 , 90–92 , 94 , 97 , 102 , 105–107 The timeliness of feedback enabled the data to be viewed as more credible and representative of performance. 21 , 22 , 24 , 26 , 27 , 31 , 33 , 39 , 41 , 44 , 52 , 55 , 57 , 58 , 66 , 70 , 71 , 75 , 76 , 80 , 82 , 83 , 86–88 , 90–92 , 94 , 97 , 101 , 102 , 105–107 Importantly, it was reported as a prerequisit...…”

“…Nevertheless, within a strong organizational context, individual clinician performance feedback (even without patient lists) given to “managerial” users or senior staff, particularly from leadership or management, was also effective. 27 , 33 , 39 , 44 , 59 , 73 , 74 , 86 , 87 , 95 , 100 Although this entailed an extra step to deliver feedback to frontline care staff and often required good interdisciplinary collaboration, the process appeared to increase motivation and accountability. 27 , 39 , 59 , 86 , 87 , 95 , 100 This process influenced individual users to take ownership of the feedback, including the responsibility to directly address the care gaps highlighted and prevented the assumption that someone else would.…”

Improving Timely Resident Follow-Up and Communication of Results in Ambulatory Clinics Utilizing a Web-Based Audit and Feedback Module

“…The basic software interface is flexible and could be modified by other training programs or institutions. 9 Limitations of this work include data self-report and a lack of resources to check the accuracy of reported data. In addition, the project focused on individual performance rather than larger systems, and improvements may not be sustained.…”

Perspektif Mahasiswa: Evaluasi Program Pendidikan Profesi Dokter Rotasi Kedokteran Keluarga di Fakultas Kedokteran Universitas Padjadjaran, Bandung Indonesia

“…8 Program evaluasi harus dilakukan sesuai kebutuhan di lapangan. 9,10 Keterbatasan penelitian ini adalah adanya bias dalam mengisi kuesioner ini karena peserta didik menjawab sendiri kuesioner tersebut. Simpulan penelitian ini adalah sebagian besar responden menyatakan kegiatan PSPD ini sudah sesuai dengan kompetensi yang harus didapat oleh mahasiswa dan dapat dicapai melalui metode pembelajaran yang diberikan.…”