Meta-Analysis

Audit and Feedback Features Impact Effectiveness on Care Quality

Bibliographic Data

ID9101231
AuthorsSylvia J Hysong (0000-0002-9063-5207, United States Department of Veterans Affairs, corresponding author)
Year2009
Volume47
Issue3
Pages356-363
Publication date2009-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181893f6b
PMID19194332
PMCIDPMC4170834
OpenAlexW1964916989
LanguageEN
Citations received14
References cited21

BACKGROUND: Audit and feedback (A&F) has long been used to improve quality of care, albeit with variable results. This meta-analytic study tested whether Feedback Intervention Theory, a framework from industrial/organizational psychology, explains the observed variability in health care A&F research. DATA SOURCE: studies cited by Jamtvedt's 2006 Cochrane systematic review of A&F, followed by database searches using the Cochrane review's search strategy to identify more recent studies. INCLUSION CRITERIA: Cochrane review criteria, plus: presence of a treatment group receiving only A & F; a control group receiving no intervention; a quantitatively measurable outcome; minimum n of 10 per arm; sufficient statistics for effect size calculations. Moderators: presence of discouragement and praise; correct solution, attainment level, velocity, frequency, and normative information; feedback format (verbal, textual, graphic, public, computerized, group vs. individual); goal setting activity. PROCEDURE: meta-analytic procedures using the Hedges-Olkin method. RESULTS: Of 519 studies initially identified, 19 met all inclusion criteria. Studies were most often excluded due to the lack of a feedback-only arm. A&F has a modest, though significant positive effect on quality outcomes (d = 0.40, 95% confidence interval = +/-0.20); providing specific suggestions for improvement, written, and more frequent feedback strengthened this effect, whereas graphical and verbal feedback attenuated this effect. CONCLUSIONS: A&F effectiveness is improved when feedback is delivered with specific suggestions for improvement, in writing, and frequently. Other feedback characteristics could also potentially improve effectiveness; however, research with stricter experimental controls is needed to identify the specific feedback characteristics that maximize its effectiveness

Audit · Cochrane Library · Confidence interval · Intervention (counseling) · MEDLINE · Meta-analysis · Normative · Outcome (game theory) · Praise · Psychiatry · Statistics · Applied Psychology · Health Policy Implementation Science · Internal Medicine · Mathematics · Medicine · Meta-analysis and systematic reviews · Patient Satisfaction in Healthcare · Psychology · Social Psychology

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