Abstract
ObjectivesTo explain the use of feedback reports for quality improvements by the reasons to participate in quality measuring projects and to identify barriers and facilitators.DesignMixed methods design.MethodsIn 2009–2011 a national audit and feedback system for physical therapy (Qualiphy) was initiated in the Netherlands. After each data collection round, an evaluation survey was held amongst its participants. The evaluation survey data was used to explain the use of feedback reports by studying the reasons to participate with Qualiphy with correlation measures and logistic regression. Semi-structured interviews with PTs served to seek confirmation and disentangle barriers and facilitators.ResultsAnalysis of 257 surveys (response rate: 42.8%) showed that therapists with only financial reasons were less likely to use feedback reports (OR = 0.24;95%CI = 0.11–0.52) compared to therapists with a mixture of reasons. PTs in 2009 and 2010 were more likely to use the feedback reports for quality improvement than PTs in 2011 (OR = 2.41;95%CI = 1.25–4.64 respectively OR = 3.28;95%CI = 1.51–7.10). Changing circumstances in 2011, i.e. using EHRs and financial incentives, had a negative effect on the use of feedback reports (OR = 0.40, 95%CI = 0.20–0.78). Interviews with 12 physical therapists showed that feedback reports could serve as a tool to support and structure quality improvement plans. Barriers were distrust and perceived self-reporting bias on indicator scores.ConclusionsImplementing financial incentives that are not well-specified and well-targeted can have an adverse effect on using feedback reports to improve quality of care. Distrust is a major barrier to implementing quality systems.
Highlights
Measuring the quality of care with quality indicators (QIs) has become part of the care giving process nowadays [1]
Interviews with 12 physical therapists showed that feedback reports could serve as a tool to support and structure quality improvement plans
Implementing financial incentives that are not well-specified and well-targeted can have an adverse effect on using feedback reports to improve quality of care
Summary
Measuring the quality of care with quality indicators (QIs) has become part of the care giving process nowadays [1]. A qualitative study into the barriers and facilitators to use feedback reports for quality improvements [10] indicated that fostering loyalty and retaining patients was a more important drive to improve the quality of care than public reporting and the use of feedback reports External incentives such as pay-for-performance incentives were found to be important motivators for the use of feedback reports to improve the quality of care [10]. Other research suggests that extrinsic stimulation such as financial stimuli can decrease intrinsic motivation, that is motivation that comes from within the person, especially when the initial intrinsic motivation is high [14,15] It can even have an adverse effect on the desired behavior, as feelings of self-control suffer from the influence of external sources trying to control the behavior [14,15]. As the disclosure of health quality data increases, the question of what triggers quality improvement best becomes noteworthy
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
