Changing health care provider performance through measurement.

Area of Science:

• Healthcare Quality Improvement
• Clinical Practice Research
• Behavioral Science in Medicine

Background:

• Assessing the impact of repeated measurements on healthcare quality is crucial for effective interventions.
• Understanding how to sustain quality improvements in clinical settings remains a key challenge.
• Existing methods for improving protocol adherence often require significant resource investment.

Purpose of the Study:

• To determine if repeated measurement of protocol adherence can enhance healthcare quality.
• To evaluate the long-term effects of such measurements on clinician behavior.
• To assess the feasibility of quality improvement through repeated external peer measurement.

Main Methods:

• A ten-week study involving 96 clinicians focused on repeated measurement of protocol adherence.
• The intervention included information, encouragement, scrutiny, and regular contact with a research team.
• Protocol adherence was examined during the study and 18 months post-intervention for a subset of participants.

Main Results:

• Repeated measurement led to significant improvements in quality of care immediately and up to 18 months later.
• Clinician behavior changed significantly during the study, with a sustained 5% improvement in quality observed 18 months later.
• No additional training, equipment, supplies, or material incentives were required for the observed improvements.

Conclusions:

• Repeated measurement by external peers can effectively improve healthcare quality by serving as reminders of expectations.
• This intervention demonstrates a sustainable method for enhancing protocol adherence and quality of care.
• The findings suggest a low-cost, high-impact strategy for quality improvement in clinical practice.