Gupta Rakesh, Mercuri Mathew, McCulloch Amy, Monteiro Sandra, Mastoras George, Krywenky Ashley, Chan Teresa, Mondoux Shawn
Division of Emergency Medicine, McMaster University, Hamilton, ON.
McMaster University, Hamilton, ON.
CJEM. 2020 Jul;22(4):542-548. doi: 10.1017/cem.2020.348.
Audit and feedback is widely used to improve physician performance. Many data metrics are being provided to physicians, yet most of these are driven by the regulatory environment. We sought to conduct a needs assessment of audit and feedback metrics that were most useful to clinicians within our health care region.
We conducted a Web-based survey of five clinical practice sites in our region and asked that physicians rank 49 clinical practice metrics. In addition, we assessed their readiness for audit and feedback and their preferences for data confidentiality. We collected data on duration of training, gender, and site of practice (academic v. community) allowing for comparison between groups.
A total of 104 emergency medicine physicians participated in the survey (52.3% response rate). There was a significant readiness for participation in audit and feedback activities. Top ranked metrics were emergency department return rates and colleague's assessment of collegiality and quality of care, which were common across all sites. Small yet significant differences were noted between genders and academic v. community practitioners.
This study represents the first regional analysis of physician preferences for audit and feedback activities and implementation. It demonstrates that physicians are interested in audit and feedback activities and provides a roadmap for the development of a regional audit and feedback structure. It will also be used as a guiding document for regional change management.
审核与反馈被广泛用于改善医生的绩效。目前向医生提供了许多数据指标,但其中大多数是由监管环境驱动的。我们试图对本医疗保健区域内对临床医生最有用的审核与反馈指标进行需求评估。
我们对本区域的五个临床实践点进行了一项基于网络的调查,要求医生对49项临床实践指标进行排序。此外,我们评估了他们对审核与反馈的准备情况以及对数据保密的偏好。我们收集了培训时长、性别和执业地点(学术型与社区型)的数据,以便进行组间比较。
共有104名急诊医学医生参与了调查(回复率为52.3%)。参与审核与反馈活动的意愿很高。排名靠前的指标是急诊科复诊率以及同事对合作性和医疗质量的评估,这些在所有实践点都很常见。在性别以及学术型与社区型从业者之间发现了虽小但显著的差异。
本研究是对医生对审核与反馈活动及实施的偏好进行的首次区域分析。它表明医生对审核与反馈活动感兴趣,并为建立区域审核与反馈结构提供了路线图。它还将用作区域变革管理的指导文件。