Beyond quality improvement: exploring why primary care teams engage in a voluntary audit and feedback program

Area of Science:

• Healthcare Management
• Quality Improvement Science
• Primary Care Research

Background:

• Audit and feedback interventions show mixed effectiveness for quality improvement.
• Research has focused on feedback design, neglecting motivational factors for engagement.
• This study explores motivations driving participation in a voluntary audit and feedback initiative within primary care.

Purpose of the Study:

• To identify the motivating factors influencing primary care teams' participation in a voluntary audit and feedback program.
• To understand drivers beyond direct quality improvement goals.
• To inform the development of more engaging and effective feedback interventions.

Main Methods:

• Conducted interviews with leaders from 18 primary care teams in Ontario, Canada.
• Utilized the Consolidated Framework for Implementation Research for coding interview transcripts.
• Analyzed coded data inductively to identify key themes and motivational factors.

Main Results:

• Motivations extended beyond quality improvement, including the belief in the program becoming 'best-in-class'.
• Perceived obligation and support for the work were key enablers for participation.
• Teams prioritized initiatives aligning with their own long-term system goals and patient outcomes; no team cited the evidence base for audit and feedback as a motivator.

Conclusions:

• Participation in audit and feedback programs is influenced by diverse factors, not solely quality improvement.
• Engaging clinical teams requires understanding and aligning with their long-term system goals.
• Optimizing audit and feedback interventions necessitates considering factors beyond developer control to enhance engagement and impact.