365: Audit and feedback effective in improving professional practice

October 19, 2012

PEARLS 365, written by Brian R McAvoy

Clinical question; How effective are audit and feedback on the practice of health.care professionals and on patient outcomes?

Bottom line: Audit and feedback generally led to small but potentially important improvements in professional practice. Feedback was more effective when baseline performance was low, when the source was a supervisor or senior colleague, when it was provided more than once, when it was delivered both verbally and written down, and when it included both measurable targets and an action plan. The effect size varied based on the particular clinical behavior targeted by the intervention.

Caveat: Most of the studies measured the effects of audit and feedback on doctors, although some of the studies measured the effect on nurses or pharmacists. It was uncertain whether audit and feed.back were more effective when combined with other interventions.

Context: Audit and feedback is widely used as a strategy to improve professional practice either on its own or as a component of multi.faceted quality.improvement interventions. This is based on the belief that healthcare professionals are prompted to modify their practice when given performance feedback showing that their clinical practice is inconsistent with a desirable target.

Cochrane Systematic Review; Ivers N et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Reviews, 2012, Issue 6. Article No. CD00259. DOI: 10.1002/14651858.CD00259.pub3. This review contains 140 studies involving more than 20,215 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.