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Practice Feedback Interventions: 15 Suggestions for Optimizing EffectivenessPractice Feedback Interventions

Jamie C. Brehaut, PhD; Heather L. Colquhoun, PhD; Kevin W. Eva, PhD; Kelly Carroll, MA; Anne Sales, PhD; Susan Michie, PhD; Noah Ivers, MD, PhD; and Jeremy M. Grimshaw, MD, PhD
[+] Article, Author, and Disclosure Information

This article was published at www.annals.org on 23 February 2016.


From Ottawa Hospital Research Institute, The Ottawa Hospital, and School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada; Occupational Science and Occupational Therapy, University of Toronto, and Women's College Hospital, Toronto, Ontario, Canada; Centre for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada; Veterans Affairs Ann Arbor Healthcare System and University of Michigan Medical School, Ann Arbor, Michigan; and University College London, London, United Kingdom.

Note: Dr. Brehaut affirms that the manuscript is an honest, accurate, and transparent account of the study and that no important aspects have been omitted.

Acknowledgment: The authors thank the 28 interviewed feedback experts whose thoughts inspired and informed many of the ideas presented.

Grant Support: By the Canadian Institutes of Health Research (MOP#130354). Dr. Ivers is supported by New Investigator Awards from the Canadian Institutes of Health Research and the Department of Family and Community Medicine, University of Toronto. Dr. Grimshaw is supported by a Canada Research Chair in Health Knowledge Transfer and Uptake.

Disclosures: Dr. Brehaut reports grants from the Canadian Institutes of Health Research during the conduct of the study. Dr. Grimshaw reports grants from the Canadian Institutes of Health Research during the conduct of the study. Authors not named here have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOf InterestForms.do?msNum=M15-2248.

Reproducible Research Statement:Study protocol: Available from Dr. Brehaut (e-mail, jbrehaut@ohri.ca). Statistical code and data set: Not available.

Requests for Single Reprints: Jamie C. Brehaut, PhD, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice Changing Research, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201B, Ottawa, Ontario K1H 8L6, Canada; e-mail, jbrehaut@ohri.ca.

Current Author Addresses: Dr. Brehaut and Ms. Carroll: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice Changing Research, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201B, Ottawa Ontario K1H 8L6, Canada.

Dr. Colquhoun: Department of Occupational Science and Occupational Therapy, University of Toronto, 160–500 University Avenue, Toronto, Ontario M5G 1V7, Canada.

Dr. Eva: Centre for Health Education Scholarship, Department of Medicine, University of British Columbia, 910 West 10th Avenue, Vancouver, British Columbia V5Z 1M9, Canada.

Dr. Sales: Department of Learning Health Sciences, University of Michigan Medical School, 1111 Catherine Street, Ann Arbor, MI 48109.

Dr. Michie: Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom.

Dr. Ivers: Department of Family Medicine, Women's College Hospital, 77 Grenville Street, Toronto, Ontario M5S 1B3, Canada.

Dr. Grimshaw: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice Changing Research, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 711, Ottawa, Ontario K1H 8L6, Canada.

Author Contributions: Conception and design: J.C. Brehaut, H.L. Colquhoun, K.W. Eva, K. Carroll, A. Sales, S. Michie, J.M. Grimshaw.

Analysis and interpretation of the data: J.C. Brehaut, H.L. Colquhoun, K.W. Eva, K. Carroll, A. Sales, N. Ivers, J.M. Grimshaw.

Drafting of the article: J.C. Brehaut, H. Colquhoun, A. Sales, S. Michie, J.M. Grimshaw.

Critical revision of the article for important intellectual content: J.C. Brehaut, H.L. Colquhoun, K.W. Eva, K. Carroll, A. Sales, S. Michie, N. Ivers, J.M. Grimshaw.

Final approval of the article: J.C. Brehaut, H.L. Colquhoun, K.W. Eva, K. Carroll, A. Sales, S. Michie, N. Ivers, J.M. Grimshaw.

Obtaining of funding: J.C. Brehaut, H.L. Colquhoun.

Administrative, technical, or logistic support: K. Carroll.

Collection and assembly of data: J.C. Brehaut, H.L. Colquhoun, K. Carroll.


Ann Intern Med. 2016;164(6):435-441. doi:10.7326/M15-2248
© 2016 American College of Physicians
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Electronic practice data are increasingly being used to provide feedback to encourage practice improvement. However, evidence suggests that despite decades of experience, the effects of such interventions vary greatly and are not improving over time. Guidance on providing more effective feedback does exist, but it is distributed across a wide range of disciplines and theoretical perspectives.Through expert interviews; systematic reviews; and experience with providing, evaluating, and receiving practice feedback, 15 suggestions that are believed to be associated with effective feedback interventions have been identified. These suggestions are intended to provide practical guidance to quality improvement professionals, information technology developers, educators, administrators, and practitioners who receive such interventions. Designing interventions with these suggestions in mind should improve their effect, and studying the mechanisms underlying these suggestions will advance a stagnant literature.

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