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    Data feedback is not enough to change care

    J. Stuart Wolf, Jr., MDJ. Stuart Wolf, Jr., MD

    Dr. Wolf, a member of the Urology Times Editorial Council, is professor and associate chair for clinical integration and operations, department of surgery and perioperative care, Dell Medical School at the University of Texas at Austin.

     

    The work of Kaplan and associates from UCLA, highlighted in the June 2017 issue of Urology Times, provides a sobering reminder of the difficulties in changing physician practice. Briefly, the authors found that data feedback, in this case about adherence to BPH management protocols, was insufficient—as the sole strategy—to improve care more than modestly.

    Read: Urologists show low adherence to value-based care pathway

    Data feedback has assumed a prominent role in quality improvement efforts in health care, with varying success. Data dashboards are frequently used by clinical and operational leaders to inform decisions about quality improvement targets. This feedback is an integral part of the “Plan-Do-Check-Adjust” cycle of quality improvement.

    Also see: Congress says 'no' to Trump NIH budget cuts

    Data feedback directly to physicians and other providers, however, often is less effective. We have all seen monitors or posters displaying time since the last accident at work, monthly adherence to hand-washing, rate of re-admission within 30 days for this or that diagnosis, or similar metrics. There is no doubt that in some cases—where the barriers to quality improvement are minimal and the physician motivation to change practice exceeds the reasons not to do so—these simple data feedbacks can induce impressive improvements. In other settings, including that of Kaplan and associates, data feedback alone is not adequate.

    Next: "What is most impactful is collaborative provider engagement and intervention that is based on the data."

    J. Stuart Wolf, Jr, MD
    Dr. Wolf, a member of the Urology Times Editorial Council, is professor and associate chair for clinical integration and operations, ...

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