Multicomponent audit and feedback for colonoscopy quality improvement among potentially lower-performing endoscopists

Area of Science:

• Healthcare Quality Improvement
• Medical Education
• Endoscopy

Background:

• Multicomponent audit and feedback (A&F) initiatives combine performance reports with education to enhance healthcare quality.
• A&F interventions are most impactful for individuals with significant room for improvement, but their effectiveness hinges on active engagement.

Purpose of the Study:

• To ascertain the participation rate of potentially lower-performing endoscopists in a voluntary A&F program.
• To identify factors that facilitate or hinder endoscopist engagement with A&F.
• To document the actions endoscopists took following exposure to the A&F initiative.

Main Methods:

• An explanatory sequential mixed-methods study was employed.
• Potentially lower-performing endoscopists in Ontario were invited to a voluntary A&F initiative, with participation tracked.
• Interviews were conducted with participants to explore their experiences, followed by directed and conventional content analyses.

Main Results:

• Out of 885 endoscopists, 121 were identified as potentially lower-performing; only 20.7% (25) participated in the A&F initiative.
• Interviews with 11 endoscopists revealed 18 facilitators and 11 barriers to participation.
• Some participants modified their practices to improve quality, documentation accuracy, or to enhance future A&F report appearance.

Conclusions:

• The low participation rate and varied responses highlight the complexity of A&F initiatives.
• Careful design and evaluation are crucial for optimizing the impact of A&F interventions in healthcare settings.