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Delayed Feedback of Physician Performance Versus Immediate Reminders to Perform Preventive CareEffects on Physician Compliance

 

作者: William Tierney,   Siu Hui,   Clement McDonald,  

 

期刊: Medical Care  (OVID Available online 1986)
卷期: Volume 24, issue 8  

页码: 659-666

 

ISSN:0025-7079

 

年代: 1986

 

出版商: OVID

 

关键词: audit/feedback;computers;decision making;physician compliance;preventive care

 

数据来源: OVID

 

摘要:

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 < 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.

 

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