Performance Feedback in Health Care

NCT ID: NCT04579614

Last Updated: 2020-10-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

595 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-09-23

Study Completion Date

2019-12-31

Brief Summary

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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

Detailed Description

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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.

Conditions

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Influenza

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Providers are randomized to receive one of three designs of performance feedback, related to their rate of successful flu vaccinations among total flu opportunities
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants
Providers do not know that that multiple arms of performance feedback designs exist for this study.

Study Groups

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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.

Group Type ACTIVE_COMPARATOR

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

Intervention Type BEHAVIORAL

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.

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.

Group Type EXPERIMENTAL

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

Intervention Type BEHAVIORAL

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.

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.

Group Type EXPERIMENTAL

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

Intervention Type BEHAVIORAL

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.

Interventions

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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.

Intervention Type BEHAVIORAL

Eligibility Criteria

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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
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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London School of Economics and Political Science

OTHER

Sponsor Role collaborator

Kaiser Permanente

OTHER

Sponsor Role lead

Responsible Party

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Felipe Lobelo

Physician Program Director, Epidemiology, Public Health, and Preparedness

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Kaiser Permanente Georgia Regional Offices

Atlanta, Georgia, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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1535959-1

Identifier Type: -

Identifier Source: org_study_id

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