Data feedback efforts in quality improvement: lessons learned from US hospitals

Abstract

Background: Data feedback is a fundamental component of quality improvement efforts, but previous studies provide mixed results on its effectiveness. This study illustrates the diversity of hospital based efforts at data feedback and highlights successful strategies and common pitfalls in designing and implementing data feedback to support performance improvement. Methods: Open ended interviews with 45 clinical and administrative staff in eight US hospitals in 2000 concerning their perceptions about the effectiveness of data feedback in supporting performance improvement efforts were analysed. The hospitals were chosen to represent a range of sizes, geographical regions, and b blocker improvement rates over a 3 year period. Data were organized and analyzed in NUD-IST 4 using the constant comparative method of qualitative data analysis. Results: Although the data feedback efforts at the hospitals were diverse, the interviews suggested that seven key themes may be important: (1) data must be perceived by physicians as valid to motivate change; (2) it takes time to develop the credibility of data within a hospital; (3) the source and timeliness of data are critical to perceived validity; (4) benchmarking improves the meaningfulness of data feedback; (5) physician leaders can enhance the effectiveness of data feedback; (6) data feedback that profiles an individual physician's practices can be effective but may be perceived as punitive; (7) data feedback must persist to sustain improved performance. Embedded in several themes was the view that the effectiveness of data feedback depends not only on the quality and timeliness of the data, but also on the organizational context in which such efforts are implemented. Conclusions: Data feedback is a complex and textured concept. Data feedback strategies that might be most effective are suggested, as well as potential pitfalls in using data to promote performance improvement.

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

“…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.…”

“…Strategies used to increase the credibility of the data included nurses sitting alongside doctors to demonstrate that they could accurately abstract information from patients' notes in order to create the feedback reports and to investigate any perceived inaccuracies with the data quickly 'until we're sure it's clean'. 224 Finally, participants also explained that the timeliness of the data and the ways in which they were presented were also central to their perceived credibility. In particular, participants felt that collecting 'real-time' data that were 'no more than 3-6 months old' and ensuring that they were presented by someone who was 'clinically competent' were important ingredients in maintaining the credibility of the data.…”

The Information Transparency Effects of Introducing League Tables in the Health System in Malawi

“…Others have defined feedback as motivation in respect to goal driven efforts (Shute, 2007;Ilgen et al, 1979). The significance of feedback has been highlighted in research and practice not only in learning and instruction (Mory, 2004) but also in information systems (Bradley et al, 2004). Feedback is one of the elements of a health information system aimed at improving data quality and decision making.…”

Enhancing safety culture and event reporting: Insights from clinicians and administrators

“…As part of the hospital's corporate safety plan, a multi-pronged approach to improving event reporting and safety culture was developed using recommendations from national organizations [11,12] and empirical work demonstrating the effectiveness of interventions (e.g. education and training, publications and newsletters, incentives and rewards to report safety events, and online networks) [1,[5][6][7][12][13][14][15][16] . SafetyNET was developed with a team of researchers, administrators, clinicians, and educators with expertise in patient safety and quality improvement.…”