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报告医疗保健结果的反馈以提高护理质量:一项范围综述

Reporting feedback on healthcare outcomes to improve quality in care: a scoping review.

作者信息

Ali Mariam P, Visser Elyke H, West Rachel L, van Noord Desirée, van der Woude C Janneke, van Deen Welmoed K

机构信息

Division of Health Technology Assessment, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.

Smarter Choices for Better Health, Outcomes-Based Health Care Action Line, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands.

出版信息

Implement Sci. 2025 Mar 25;20(1):14. doi: 10.1186/s13012-025-01424-9.

Abstract

BACKGROUND

Providing healthcare providers (HCPs) feedback on their practice patterns and achieved outcomes is a mild to moderately effective strategy for improving healthcare quality. Best practices for providing feedback have been proposed. However, it is unknown how these strategies are implemented in practice and what their real-world effectiveness is. This scoping review addresses this gap by examining the use and reported impact of feedback reporting practices in various clinical fields.

METHODS

A systematic review of the literature was conducted, and electronic databases were searched for publications in English between 2010-June 2024. We included studies that utilized and evaluated feedback reporting to change HCP behaviours and enhance outcomes, using either qualitative or quantitative designs. Two researchers reviewed and extracted data from full texts of eligible studies, including information on study objectives, types of quality indicators, sources of data, types of feedback reporting practices, and co-interventions implemented.

RESULTS

In 279 included studies we found that most studies implemented best practices in reporting feedback, including peer comparisons (66%), active delivery of feedback (65%), timely feedback (56%), feedback specific to HCPs' practice (37%), and reporting feedback in group settings (27%). The majority (68%) combined feedback with co-interventions, such as education, post-feedback consultations, reminders, action toolboxes, social influence, and incentives. 81% showed improvement in quality indicators associated with feedback interventions. Interventions targeting outcome measures were reported as less successful than those targeting process measures, or both. Feedback interventions appeared to be more successful when supplemented with post-feedback consultations, reminders, education, and action toolboxes.

CONCLUSION

This review provides a comprehensive overview of strategies used to implement feedback interventions in a wide range of practice settings. Targeting process measures or combining them with outcome measures results in more positive outcomes. Additionally, feedback interventions may be slightly more effective when combined with other interventions designed to facilitate behaviour change. These findings can provide valuable insights for others wishing to implement similar interventions.

REGISTRATION

Open Science Framework, https://doi.org/10.17605/OSF.IO/GAJVS .

摘要

背景

向医疗服务提供者(HCPs)反馈其执业模式和取得的成果是提高医疗质量的一种轻度至中度有效的策略。已经提出了提供反馈的最佳实践方法。然而,尚不清楚这些策略在实际中是如何实施的,以及它们在现实世界中的有效性如何。本范围综述通过研究反馈报告实践在各个临床领域的应用及所报告的影响来填补这一空白。

方法

对文献进行系统综述,在电子数据库中搜索2010年至2024年6月期间的英文出版物。我们纳入了利用和评估反馈报告以改变HCP行为并改善结果的研究,采用定性或定量设计。两名研究人员对符合条件的研究全文进行审查并提取数据,包括研究目标、质量指标类型、数据来源、反馈报告实践类型以及实施的联合干预措施等信息。

结果

在纳入的279项研究中,我们发现大多数研究在反馈报告中实施了最佳实践,包括同行比较(66%)、主动提供反馈(65%)、及时反馈(56%)、针对HCP执业情况特定的反馈(37%)以及在小组环境中报告反馈(27%)。大多数(68%)将反馈与联合干预措施相结合,如教育、反馈后咨询、提醒、行动工具箱、社会影响和激励措施。81%的研究表明与反馈干预相关的质量指标有所改善。据报告,针对结果指标的干预不如针对过程指标的干预成功,或者针对两者的干预都不太成功。当反馈干预辅以反馈后咨询、提醒、教育和行动工具箱时,似乎更成功。

结论

本综述全面概述了在广泛的实践环境中用于实施反馈干预的策略。针对过程指标或将其与结果指标相结合会产生更积极的结果。此外,当反馈干预与旨在促进行为改变的其他干预措施相结合时,可能会稍微更有效。这些发现可为希望实施类似干预措施的其他人提供有价值的见解。

注册信息

开放科学框架,https://doi.org/10.17605/OSF.IO/GAJVS

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cab4/11934531/290f514fc78d/13012_2025_1424_Fig1_HTML.jpg

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