‘Give me something meaningful’: GPs perspectives on how to improve an audit and feedback report provided by health insurers – an exploratory qualitative study
Background Audit and feedback (A&F) is a valuable quality improvement strategy, which can contribute to de-implementation of low-value care. In the Netherlands, all health insurers collaboratively provide A&F to general practitioners (GPs), the ‘Primary Care Practice Report’ (PCPR)....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/11/4/e002006.full |
| _version_ | 1811308083892191232 |
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| author | P J G M de Bekker V de Weerdt M D H Vink A B van der Kolk M H Donker E J E van der Hijden |
| author_facet | P J G M de Bekker V de Weerdt M D H Vink A B van der Kolk M H Donker E J E van der Hijden |
| author_sort | P J G M de Bekker |
| collection | DOAJ |
| description | Background Audit and feedback (A&F) is a valuable quality improvement strategy, which can contribute to de-implementation of low-value care. In the Netherlands, all health insurers collaboratively provide A&F to general practitioners (GPs), the ‘Primary Care Practice Report’ (PCPR). Unfortunately, the use of this report by GPs is limited. This study examined the thoughts of GPs on the usability of the PCPR and GPs recommendations for improving the PCPR.Method We used an interpretative qualitative design, with think-aloud tasks to uncover thoughts of GPs on the usability of the PCPR and semistructured interview questions to ask GPs’ recommendations for improvement of the PCPR. Interviews were audiorecorded and transcribed ad verbatim. Data were analysed using thematic content analysis.Results We identified two main themes: ‘poor usability of the PCPR’, and ‘minimal motivation to change based on the PCPR’. The GPs found the usability of the PCPR poor due to the feedback not being clinically meaningful, the data not being recent, individual and reliable, the performance comparators offer insufficient guidance to assess clinical performance, the results are not discussed with peers and the definitions and visuals are unclear. The GPs recommended improving these issues. The GPs motivation to change based on the PCPR was minimal.Conclusions The GPs evaluated the PCPR as poorly usable and were minimally motivated to change. The PCPR seems developed from the perspective of the reports’ commissioners, health insurers, and does not meet known criteria for effective A&F design and user-centred design. Importantly, the GPs did state that well-designed feedback could contribute to their motivation to improve clinical performance.Furthermore, the GPs stated that they receive a multitude of A&F reports, which they hardly use. Thus, we see a need for policy makers to invest in less, but more usable A&F reports. |
| first_indexed | 2024-04-13T09:16:59Z |
| format | Article |
| id | doaj.art-aa3729f547a84629b772f921c7a246a3 |
| institution | Directory Open Access Journal |
| issn | 2399-6641 |
| language | English |
| last_indexed | 2024-04-13T09:16:59Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj.art-aa3729f547a84629b772f921c7a246a32022-12-22T02:52:43ZengBMJ Publishing GroupBMJ Open Quality2399-66412022-11-0111410.1136/bmjoq-2022-002006‘Give me something meaningful’: GPs perspectives on how to improve an audit and feedback report provided by health insurers – an exploratory qualitative studyP J G M de Bekker0V de Weerdt1M D H Vink2A B van der Kolk3M H Donker4E J E van der Hijden5Department of Health Economics & Talma Institute, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsDepartment of Health Economics & Talma Institute, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsDepartment of Health Economics & Talma Institute, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsTalma Institute, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsDepartment of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsDepartment of Health Economics & Talma Institute, Vrije Universiteit Amsterdam, Amsterdam, NetherlandsBackground Audit and feedback (A&F) is a valuable quality improvement strategy, which can contribute to de-implementation of low-value care. In the Netherlands, all health insurers collaboratively provide A&F to general practitioners (GPs), the ‘Primary Care Practice Report’ (PCPR). Unfortunately, the use of this report by GPs is limited. This study examined the thoughts of GPs on the usability of the PCPR and GPs recommendations for improving the PCPR.Method We used an interpretative qualitative design, with think-aloud tasks to uncover thoughts of GPs on the usability of the PCPR and semistructured interview questions to ask GPs’ recommendations for improvement of the PCPR. Interviews were audiorecorded and transcribed ad verbatim. Data were analysed using thematic content analysis.Results We identified two main themes: ‘poor usability of the PCPR’, and ‘minimal motivation to change based on the PCPR’. The GPs found the usability of the PCPR poor due to the feedback not being clinically meaningful, the data not being recent, individual and reliable, the performance comparators offer insufficient guidance to assess clinical performance, the results are not discussed with peers and the definitions and visuals are unclear. The GPs recommended improving these issues. The GPs motivation to change based on the PCPR was minimal.Conclusions The GPs evaluated the PCPR as poorly usable and were minimally motivated to change. The PCPR seems developed from the perspective of the reports’ commissioners, health insurers, and does not meet known criteria for effective A&F design and user-centred design. Importantly, the GPs did state that well-designed feedback could contribute to their motivation to improve clinical performance.Furthermore, the GPs stated that they receive a multitude of A&F reports, which they hardly use. Thus, we see a need for policy makers to invest in less, but more usable A&F reports.https://bmjopenquality.bmj.com/content/11/4/e002006.full |
| spellingShingle | P J G M de Bekker V de Weerdt M D H Vink A B van der Kolk M H Donker E J E van der Hijden ‘Give me something meaningful’: GPs perspectives on how to improve an audit and feedback report provided by health insurers – an exploratory qualitative study BMJ Open Quality |
| title | ‘Give me something meaningful’: GPs perspectives on how to improve an audit and feedback report provided by health insurers – an exploratory qualitative study |
| title_full | ‘Give me something meaningful’: GPs perspectives on how to improve an audit and feedback report provided by health insurers – an exploratory qualitative study |
| title_fullStr | ‘Give me something meaningful’: GPs perspectives on how to improve an audit and feedback report provided by health insurers – an exploratory qualitative study |
| title_full_unstemmed | ‘Give me something meaningful’: GPs perspectives on how to improve an audit and feedback report provided by health insurers – an exploratory qualitative study |
| title_short | ‘Give me something meaningful’: GPs perspectives on how to improve an audit and feedback report provided by health insurers – an exploratory qualitative study |
| title_sort | give me something meaningful gps perspectives on how to improve an audit and feedback report provided by health insurers an exploratory qualitative study |
| url | https://bmjopenquality.bmj.com/content/11/4/e002006.full |
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