Audit Reviewed: Does Feedback on Performance Change Clinical Behaviour?

Often the cycle is incomplete because no attempt is made to change clinical practice. It is commonly assumed that the information produced by audit will naturally lead to change. In this article we review some past experiences with feedback of information and consider whether the evidence supports the assumption that the provision of information on performance changes clinical behaviour. Information feedback c^n be divided into two broad categories?passive and active. Passive feedback consists of supplying information without any overtly evaluative material or suggestions for improvement. The information is usually relayed to clinicians in the form of statistics in newsletters or computer printouts. Often the statistics may be ranked according to the levels pertaining to the consultants or junior doctors in receipt of the information.

[1]  H. Ma.  Scottish Consultant Review of In-patient Statistics (SCRIPS). , 1970 .

[2]  J. K. Cooper,et al.  Use of laboratory tests and pharmaceuticals. Variation among physicians and effect of cost audit on subsequent use. , 1973, JAMA.

[3]  F. Dyck,et al.  Effect of surveillance on the number of hysterectomies in the province of Saskatchewan. , 1977, The New England journal of medicine.

[4]  Heath Da,et al.  Medical Audit in General Medicine , 1981, Journal of the Royal College of Physicians of London.

[5]  S. Gehlbach,et al.  Effects of an educational feedback strategy on physician utilization of thyroid function panels. , 1979, The Journal of family practice.

[6]  M W Pozen,et al.  The impact on house officers of educational and administrative interventions in an outpatient department. , 1976, Social science & medicine.

[7]  P. Chang,et al.  Effect of cost education, cost audits, and faculty chart review on the use of laboratory services. , 1983, Archives of Internal Medicine.

[8]  F. Wenzel,et al.  Cholecystectomy Peer Review: Measurement of Four Variables , 1975, Medical Care.

[9]  Medical audit cycle. A review of methods and research in clinical practice. , 1982 .

[10]  J. Restuccia,et al.  The Effect of Concurrent Feedback in Reducing Inappropriate Hospital Utilization , 1982, Medical care.

[11]  A. Gittelsohn,et al.  Changes in tonsillectomy rates associated with feedback and review. , 1977, Pediatrics.

[12]  C R Brown,et al.  Mandatory continuing education. Sense or nonsense? , 1970, JAMA.

[13]  J. Harris,et al.  Teaching cost containment to house officers at Charlotte Memorial Hospital. , 1979, Journal of medical education.

[14]  C G Fraser,et al.  League tables of biochemical laboratory costs. An attempt to modify requesting patterns. , 1982, The Medical journal of Australia.

[15]  J. Eisenberg,et al.  Computer-based Audit to Detect and Correct Overutilization of Laboratory Tests , 1977, Medical care.

[16]  J. Coles,et al.  Review of clinical budgeting and costing experiments , 1983, British medical journal.

[17]  L. A. Thibodeau,et al.  A trial of two strategies to modify the test-ordering behavior of medical residents. , 1980, The New England journal of medicine.

[18]  C G Fraser,et al.  Effect of feedback to clinical staff of information on clinical biochemistry requesting patterns. , 1981, Clinical chemistry.