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Audit and feedback: effects on professional practice.

Noah Ivers1, Sharlini Yogasingam2, Meagan Lacroix3

  • 1Department of Family and Community Medicine, Women's College Hospital, Toronto, Canada.

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|March 25, 2025
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Summary
This summary is machine-generated.

Audit and feedback (A&F) improves healthcare professional practice, with effects varying by design. Key elements for greater impact include individual-level data, peer comparisons, local champions, and actionable plans.

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Area of Science:

  • Health Services Research
  • Behavioral Science in Medicine
  • Quality Improvement

Background:

  • Audit and feedback (A&F) is a common strategy to enhance healthcare professional practice.
  • Existing evidence and behavioral theories support A&F's potential to modify practice.
  • Uncertainty remains regarding A&F's overall effectiveness and optimal design characteristics.

Purpose of the Study:

  • To evaluate the impact of A&F on healthcare professional practice.
  • To identify factors influencing the variability in A&F effectiveness.

Main Methods:

  • Systematic review and meta-analysis of randomized trials, including cluster-randomized trials.
  • Data extraction on A&F characteristics, behavior change techniques, and practice outcomes.
  • Meta-regression analysis to explore heterogeneity and identify effective A&F components.

Main Results:

  • Included 292 studies with 678 arms; 46% had low risk of bias.
  • A&F demonstrated a mean absolute increase in desired practice of 6.2% (moderate-certainty evidence).
  • Effectiveness was enhanced by individual-level data, peer comparisons, local champions, interactive feedback, and actionable plans.

Conclusions:

  • Audit and feedback can effectively improve professional practice, with significant variation in impact.
  • Optimizing A&F effectiveness involves targeting key performance metrics, using individual data, peer benchmarking, and facilitating action planning.
  • Further research is needed to refine A&F interventions for maximum impact on healthcare quality.