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Publication Briefs

Study Reports on Improving Audit and Feedback Strategies

Audit and feedback (A&F) has long been used to change provider behavior, thereby improving the quality of healthcare. A&F furnishes providers with summaries of clinical performance over a specified period of time, offering providers current information and motivation to improve. A&F has gained renewed attention due to its role in the effectiveness of physician-based performance measurement and pay-for-performance initiatives. This meta-analysis of 19 studies sought to determine A&F characteristics that 1) positively impact provider performance, 2) shift the locus of attention toward the details of the task so that the effect of A&F will enhance performance, and 3) shift the locus of attention away from details that will attenuate the effect of A&F on performance.

Study findings show that A&F has a modest but significant positive effect on quality outcomes. A&F reports containing specific suggestions for performance improvements - delivered in writing, rather than verbally or graphically, and delivered frequently - can noticeably improve the effectiveness of audit and feedback. Also, providing combined group- and individual-level feedback appeared to positively impact feedback effectiveness; however, definitive conclusions could not be made.

PubMed Logo Hysong S. Meta-analysis: Audit and feedback features impact effectiveness on care quality. Medical Care March 2009;47(3):356-363.

This study was partly funded by HSR&D. Dr. Hysong is part of HSR&D's Houston Center for Quality of Care and Utilization Studies.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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