In the Journals

Half of quality improvement studies found ineffective

While researchers reported that audit and feedback can potentially improve the quality of health care, results from a new study indicate that only half of all quality improvement studies lead to improvements in medical practices.

Investigators at Women’s College Hospital in Toronto showed that feedback and testing audits can improve quality, but the implementation of the intervention is key to achieving beneficial results.

“Research shows there is a gap between recommended practices and the care patients actually receive,” Noah M. Ivers, MD, PhD, family physician at the hospital, said in a press release. “While we have a number of studies showing that providing feedback to clinicians can act as a foundation for improving quality of care if done properly, we found, in most cases, quality improvement efforts are haphazardly implemented, reinventing the wheel rather than learning from what we already know.”

To obtain their results, Ivers and colleagues performed meta-regressions for studies the Cochrane Central Register for Controlled Trials, Medline and Embase published up to 2002, 2006 and 2010. A total of 98 comparisons from 62 studies were included in analysis, which showed that the feedback received from audits appeared to be most effective when presented by a respected colleague or supervisor, presented frequently and targeted and goal-specific.

The researchers wrote that “few trials feature these components,” and that determining how to optimize the audit and feedback process “remains difficult.”

“While we know from previous research that providing clinicians with a specific action plan for improvement is essential for providing better care for patients, feedback initiatives rarely include plans aimed at changing the behavior of health care professionals,” Ivers said in the release.

Disclosure: The researchers report no relevant financial disclosures.

While researchers reported that audit and feedback can potentially improve the quality of health care, results from a new study indicate that only half of all quality improvement studies lead to improvements in medical practices.

Investigators at Women’s College Hospital in Toronto showed that feedback and testing audits can improve quality, but the implementation of the intervention is key to achieving beneficial results.

“Research shows there is a gap between recommended practices and the care patients actually receive,” Noah M. Ivers, MD, PhD, family physician at the hospital, said in a press release. “While we have a number of studies showing that providing feedback to clinicians can act as a foundation for improving quality of care if done properly, we found, in most cases, quality improvement efforts are haphazardly implemented, reinventing the wheel rather than learning from what we already know.”

To obtain their results, Ivers and colleagues performed meta-regressions for studies the Cochrane Central Register for Controlled Trials, Medline and Embase published up to 2002, 2006 and 2010. A total of 98 comparisons from 62 studies were included in analysis, which showed that the feedback received from audits appeared to be most effective when presented by a respected colleague or supervisor, presented frequently and targeted and goal-specific.

The researchers wrote that “few trials feature these components,” and that determining how to optimize the audit and feedback process “remains difficult.”

“While we know from previous research that providing clinicians with a specific action plan for improvement is essential for providing better care for patients, feedback initiatives rarely include plans aimed at changing the behavior of health care professionals,” Ivers said in the release.

Disclosure: The researchers report no relevant financial disclosures.