New research shows performance feedback may not improve outcomes

With medical errors among the leading causes of death in the country, hospitals are looking to identify problems and address them through performance feedback. But new research published in the Journal of the American Medical Association shows that might not be enough to motivate improvement.

Laurent G. Glance, M.D., from the department of anesthesiology, University of Rochester School of Medicine, New York, and colleagues, performed an evaluation of the impact of performance reports on risk-adjusted mortality for trauma patients, having the National Trauma Data Bank provide benchmarking reports to hospitals. There was no improvement in mortality rates from pre- to post-benchmark reporting, the study states.

In the 326,206 trauma patients admitted to 44 hospitals, performance benchmarking was not significantly associated with lower in-hospital mortality rates, according to the study.

Researchers believe part of the reason is because the hospital received the report instead of individual physicians. The results may make an impact on individual physician behavior but have less impact on a large group's behavior within a trauma center, the study said.

Adding interventions to the feedback, such as structured site visits and meaningful financial incentives, would help improve trauma outcomes, researchers said. 

The study results should serve as a wake-up call on performance reports, according to an accompanying opinion piece published in JAMA. Authors Justin B. Dimick, M.D., and Samantha K. Hendren, M.D., of the department of surgery, University of Michigan, said the study shows that while outcomes feedback is necessary, it isn't sufficient to improve quality.

"Developing an implementation strategy to close this improvement gap should be a top priority for any program that aims to improve outcomes," they wrote. "We need to stop hoping that surgeons and hospitals will improve on their own and start to disseminate both the data and the scientific tools to promote performance improvement."

To learn more:
- here's the study
- check out the opinion piece

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