Confidential, in-house "report cards" to doctors aren't enough to improve healthcare quality, according to a new study. Instead, hospitals and physician practices are likely to find that they must back up data with sustained support to help physicians change practice patterns.
"Simply providing report cards, especially on a single, one-time basis, doesn't achieve the desired improvement (providers) are pursuing," said Todd Ketch, vice president of government affairs at the American Health Quality Association. "We've seen better results when (the information) is coupled with support."
Researchers at McGill University Health Centre in Montreal measured how many elderly patients filled a prescription for a beta-blocker within 30 days of discharge after a heart attack -- a common measure of quality. Half of the hospitals in the study received "rapid feedback" in the form of report cards as soon as the data were randomized, and the other half got the report cards 14 months later.
Compliance rose 9.6% at rapid-feedback hospitals and 5.4% at delayed-feedback hospitals, a statistically insignificant difference, according to the study in the July 20 issue of the Journal of the American Medical Association.
Even rapid-feedback hospitals, however, received 2-year-old data, Ketch said. In time, better information technology will speed data gathering, analysis and feedback and accelerate improvements.
For Nancy Foster, vice president for quality and patient-safety policy at the American Hospital Association, the study's main lesson was that "a one-time intervention of any sort is not an effective way to achieve sustained improvement in the quality of care being offered."
Researchers conducted the study at Quebec hospitals because providers in the region had little previous experience with report cards. A second study is under way to see if physicians respond better to data drawn from chart reviews instead of administrative records.
"I suspect the impact will not be much better," study co-author Louise Pilote said in an e-mail. Pilote said the second study should be published next year.