Performance Feedback in Health Care

Kaiser Permanente

Status: Completed

Conditions: Influenza

Treatments: Behavioral: The Impact of Performance Feedback and Variable Goal Setting on Flu Vaccination Success Rates of Providers

Study type: Interventional

Funder types: Other

Identifiers

NCT04579614

1535959-1

Details and patient eligibility

About

The Southeast Permanente Medical Group (TSPMG) at Kaiser Permanente Georgia provides performance feedback to its providers. The performance feedback designs can vary and change over time in terms of targets, summary statistics, included measures, and frequency of delivery. The TSPMG health services research group seek to compare different performance feedback designs to identify which are most effective at contributing to performance improvement.

The research team will randomly assign providers into different performance feedback conditions, as specified in the protocol. Providers will receive performance feedback through the standard mechanism in which it is conveyed by their supervisor.

The objective is to investigate how to design performance feedback for providers to best motivate and support them in improving performance along with existing strategic priorities for care delivery.

The reserach team will test alternative designs of performance feedback that vary on the following dimension:

1. targets for comparison of one's own performance

Full description

The Southeast Permanente Medical Group (TSPMG) provides performance feedback to its providers. The performance feedback designs can vary and change over time in terms of targets, summary statistics, included measures, and frequency of delivery. The TSPMG health services research team will seek to compare different performance feedback designs to identify which are most effective at contributing to performance improvement. .

The research team will randomly assign providers into different performance feedback conditions, as specified in the protocol. Providers will receive performance feedback through the standard mechanism in which it is conveyed by their supervisor.

The objective is to investigate how to design performance feedback for providers to best motivate and support them in improving performance along with existing strategic priorities for care delivery.

The research team will test alternative designs of performance feedback that vary on the following dimension:

1. targets for comparison of one's own performance

The research team will provide feedback on performance by measures that the organization already tracks internally and uses for performance improvement. These include a provider's utilization of opportunities to provide flu vaccinations.

The study will randomly assign different designs of feedback to providers. In order to understand which designs of feedback have the best effects on performance, the research team will test the following hypotheses:

1. Displaying the next-highest quartile will motivate improvement more than display of all quartiles.

   Theory: The next-highest quartile will serve as an injunctive norm, or suggested target, to repeatedly lift an individual's performance to the suggested level.

2. The positive effect of displaying the next-highest quartile, relative to displaying all quartiles, will be most pronounced for initially low performers.

   Theory: The next highest quartile averts upward social comparison to a much higher level of peer performance, which can be discouraging and so negatively affect performance

3. The positive effect of displaying the next-highest quartile, relative to displaying all quartiles, will diminish over time.

   Theory: Individuals may become worn out as they see a target ratchet higher when their performance improves.

4. Displaying team relative performance along with individual relative performance will be more effective than displaying either type of information alone.

Enrollment: 595 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

A healthcare provider practicing at The Southeast Permanente Medical Group in a specialty for which the performance measure being studied is relevant.

Health care providers include:

Physicians, Nurse Practitioner, Certified Nurse Midwife, Psych Nurse Specialist, Optometrist, Podiatrist, and Physician Assistant

Exclusion criteria

Non-Physicians: Registered Nurses excluding nurse practitioners

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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595 participants in 3 patient groups

Organizational Target

Active Comparator group

Description:

Providers are shown the flu success performance rate of their team (a "pod," or group of providers who practice together), in comparison to their own, and with the organizational target. These updates and targets are sent bi-weekly.

Treatment:

Behavioral: The Impact of Performance Feedback and Variable Goal Setting on Flu Vaccination Success Rates of Providers

Achievable Target

Experimental group

Description:

Providers are shown the flu success performance rate of their team (a "pod," or group of providers who practice together), in comparison to their own. They will receive a static and achievable target based on their previous year's flu vaccination success rate.

Treatment:

Behavioral: The Impact of Performance Feedback and Variable Goal Setting on Flu Vaccination Success Rates of Providers

Variable

Experimental group

Description:

Providers are shown the flu success performance rate of their team (a "pod," or group of providers who practice together), in comparison to their own. They will receive a variable target that will fluctuate bi-weekly, based on their previous bi-weekly flu vaccination success rate.

Treatment:

Behavioral: The Impact of Performance Feedback and Variable Goal Setting on Flu Vaccination Success Rates of Providers