Performance Feedback in Health Care
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| ClinicalTrials.gov Identifier: NCT04579614 |
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Recruitment Status :
Completed
First Posted : October 8, 2020
Last Update Posted : October 8, 2020
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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
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Influenza | Behavioral: The Impact of Performance Feedback and Variable Goal Setting on Flu Vaccination Success Rates of Providers | Not Applicable |
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:
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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.
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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
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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.
- Displaying team relative performance along with individual relative performance will be more effective than displaying either type of information alone.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 595 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Intervention Model Description: | Providers are randomized to receive one of three designs of performance feedback, related to their rate of successful flu vaccinations among total flu opportunities |
| Masking: | Single (Participant) |
| Masking Description: | Providers do not know that that multiple arms of performance feedback designs exist for this study. |
| Primary Purpose: | Health Services Research |
| Official Title: | Performance Feedback in Health Care |
| Actual Study Start Date : | September 23, 2019 |
| Actual Primary Completion Date : | December 31, 2019 |
| Actual Study Completion Date : | December 31, 2019 |
| Arm | Intervention/treatment |
|---|---|
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Active Comparator: Organizational Target
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.
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Behavioral: The Impact of Performance Feedback and Variable Goal Setting on Flu Vaccination Success Rates of Providers
A given provider will be involved in the study for a maximum of 6 months. This will involve, at the most frequent, the delivery of weekly performance feedback. The performance feedback will be delivered using standard approaches already in place in the organization and there will not be a period of seeking out participants for enrollment. Providers will receive performance feedback bi-weekly for the duration of the study period. |
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Experimental: Achievable Target
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.
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Behavioral: The Impact of Performance Feedback and Variable Goal Setting on Flu Vaccination Success Rates of Providers
A given provider will be involved in the study for a maximum of 6 months. This will involve, at the most frequent, the delivery of weekly performance feedback. The performance feedback will be delivered using standard approaches already in place in the organization and there will not be a period of seeking out participants for enrollment. Providers will receive performance feedback bi-weekly for the duration of the study period. |
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Experimental: Variable
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.
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Behavioral: The Impact of Performance Feedback and Variable Goal Setting on Flu Vaccination Success Rates of Providers
A given provider will be involved in the study for a maximum of 6 months. This will involve, at the most frequent, the delivery of weekly performance feedback. The performance feedback will be delivered using standard approaches already in place in the organization and there will not be a period of seeking out participants for enrollment. Providers will receive performance feedback bi-weekly for the duration of the study period. |
- Flu Vaccination Administered During Encounter [ Time Frame: 10 Weeks ]Whether or not the providers succeeded in administering flu vaccination during flu vaccination opportunity
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
| Ages Eligible for Study: | Child, Adult, Older Adult |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | Yes |
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
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04579614
| United States, Georgia | |
| Kaiser Permanente Georgia Regional Offices | |
| Atlanta, Georgia, United States, 30305 | |
Documents provided by Felipe Lobelo, Kaiser Permanente:
| Responsible Party: | Felipe Lobelo, Physician Program Director, Epidemiology, Public Health, and Preparedness, Kaiser Permanente |
| ClinicalTrials.gov Identifier: | NCT04579614 |
| Other Study ID Numbers: |
1535959-1 |
| First Posted: | October 8, 2020 Key Record Dates |
| Last Update Posted: | October 8, 2020 |
| Last Verified: | October 2020 |
| Individual Participant Data (IPD) Sharing Statement: | |
| Plan to Share IPD: | No |
| Studies a U.S. FDA-regulated Drug Product: | No |
| Studies a U.S. FDA-regulated Device Product: | No |
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Flu Vaccination Provision Performance Feedback Variable Goal Setting Flu Vaccination Success Rate Health Care Providers |
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Vaccines Immunologic Factors Physiological Effects of Drugs |