Delayed Feedback of Physician Performance Versus Immediate Reminders to Perform Preventive Care

In an academic general medicine clinic, we performed a randomized, controlled trial to compare (1) the effects of supplying monthly feedback reports of compliance with preventive care protocols by 135 internal medicine house staff with (2) the effects of specific reminders given to them at the time of patient visits. The protocols were randomly divided into two groups, A and B, and half the house staff were given feedback for Group A and half for Group B. Thus, each group served as a control for the other. Each feedback group was also randomly assigned to receive reminders for either Group A or B protocols. House staff receiving feedback more often complied with fecal occult blood testing, mammography, pneumococcal vaccination, use of metronidazole, and combined Group A and B protocols than did controls (P less than 0.01). There was also significantly more compliance with the same protocols by house staff receiving reminders, but the increase for fecal occult blood testing, pneumococcal vaccination, and combined Group A protocols was twice that seen in physicians given feedback alone. In addition, reminders alone increased compliance with oral calcium supplementation. Overall compliance with the preventive care protocols was low: 10-15% in physicians receiving neither feedback nor reminders, increasing to 15-30% in those receiving reminders. Physician compliance with suggested preventive care protocols can be increased by both delayed feedback and immediate reminders, but reminders have a greater effect

Colonoscopy · Compliance (psychology) · Family medicine · Fecal occult blood · Health care · Physical therapy · Preventive care · Randomized controlled trial · Emergency Medicine · Health Promotion and Cardiovascular Prevention · Healthcare cost, quality, practices · Internal Medicine · Medicine · Primary Care and Health Outcomes · Psychology

• Changing Physician Prescribing Patterns

  Gonzalo Guti??rrez, Gonzalo Guti rrez et al.•Medical Care•1994

  Incluir item

• Influencing Behavior of Physicians Ordering Laboratory Tests

  Petra Axt-Adam, Johannes C van der Wouden et al.•Medical Care•1993

  Incluir item

• Drug Utilization Review in Ambulatory Settings

  Helene Levens Lipton, Joyce Adair Bird•Medical Care•1993

  Incluir item

• Cluster Randomized Trials of Professional and Organizational Behavior Change Interventions in Health Care Settings

  Open Access•Jeremy M Grimshaw, Jeremy Grimshaw et al.•The Annals of the American…•2005

  Incluir item

• Systematic Review

  Open Access•Basit Chaudhry, Jerome Wang et al.•Annals of Internal Medicine•2006

  Incluir item

• Interventions to improve the delivery of preventive services in primary care

  M E Hulscher, Marlies Hulscher et al.•American Journal of Public Health•1999

  Incluir item

• Promoting preventive care

  Stephen J Mcphee, S A Schroeder et al.•American Journal of Public Health•1987

  Incluir item

• Improving influenza vaccination performance in an HMO setting

  M B Barton, Stephen C Schoenbaum•American Journal of Public Health•1990

  Incluir item

• Physician financial incentives and feedback

  A L Hillman, Kimberly Ripley et al.•American Journal of Public Health•1998

  Incluir item

• Quality Enhancement Research Initiative in Ischemic Heart Disease

  Nathan R Every, Stephan D Fihn et al.•Medical Care•2000

  Incluir item

• Factors Associated With Physician Involvement in Care Management

  Teresa M Waters, Felipe Artengo Rufino et al.•Medical Care•2001

  Incluir item

• Improving physician prescribing patterns to treat rhinopharyngitis. Intervention strategies in two health systems of Mexico

  Open Access•Ricardo Pérez-Cuevas, Hector Guiscafré et al.•Social Science & Medicine•1996

  Incluir item

• Sociologic Influences on Decision-Making by Clinicians

  Open Access•John M Eisenberg•Annals of Internal Medicine•1979

  Incluir item

• The effect of immediate access to a computerized medical record on physician test ordering

  Gregory Wilson, G A Wilson et al.•American Journal of Public Health•1982

  Incluir item

• Phased trial of a proven algorithm at a new primary care clinic

  Jay Christensen-Szalanski, J J Christensen-Szalanski et al.•American Journal of Public Health•1982

  Incluir item

• Improving Physician Compliance With Preventive Medicine Guidelines

  David I Cohen, Benjamin Littenberg et al.•Medical Care•1982

  Incluir item

• The impact of reading on physicians' nonadherence to recommended standards of medical care

  Open Access•Stuart J Cohen, Morris Weinberger et al.•Social Science & Medicine•1985

  Incluir item