Improving Healthcare Professional Performance Through Audit and Feedback

Audit and feedback processes result in small-to-moderate improvements in healthcare quality, according to a review of 292 studies updated through June 2020. The process involves measuring a healthcare professional’s performance against professional standards and providing those results to the individual to encourage clinical changes.

How does audit and feedback work in healthcare?

Healthcare organizations use audit and feedback to evaluate professional practice. In the audit phase, an individual’s performance is measured and compared to specific targets or professional standards. During the feedback phase, the results of this comparison are delivered to the professional.

The review found these interventions were most frequently used to influence doctors, though the studies also included nurses and pharmacists. Common areas of focus included the ordering of tests and the proper use of prescription treatments.

Did You Know? The findings are based on a comprehensive analysis of 292 different studies that randomized healthcare professionals to receive audit and feedback.

Which factors make clinical feedback more effective?

Effectiveness varies widely, but the evidence indicates that specific delivery methods yield better results. Performance improvements are more likely when professionals can see how they compare to high-performing peers and when the feedback focuses on high-priority clinical issues where there is substantial room for improvement.

Additional features associated with greater effects include:

Measuring the individual’s practice rather than the performance of a team or organization.
Delivery by a respected peer who has an existing relationship with the recipient.
Using multiple modalities, such as combining written and verbal feedback.
Including an action plan that provides specific advice for improvement.

Expert Insight: Samantha Carter notes that the reliance on respected peer relationships and individual measurement suggests that professional accountability and social comparison are stronger drivers of change than generic organizational mandates.

What happens when feedback is combined with other supports?

Audit and feedback is often used alongside other quality-of-care strategies. The review indicates that the effect of feedback may change or improve when combined with extra training, educational meetings, or reminders.

Improving Patient Care through Clinical Audits | Healthcare Quality | Smart Management Consultancy

What happens next for healthcare audits?

Because the current quality of evidence is moderate, further research is likely to focus on confirming which specific features of audit and feedback achieve the greatest effects across different clinical situations. Future interventions may be refined to better identify the most effective delivery modes and timing for feedback.

Frequently Asked Questions

What is the primary goal of audit and feedback in healthcare?
The aim is to encourage healthcare professionals to take action or make changes to their practice so they follow professional standards.

Who is typically affected by these audit processes?
While most studies focused on doctors, the process is also applied to nurses and pharmacists.

In what ways is feedback usually delivered to professionals?
Feedback may be delivered verbally, in writing, via an electronic dashboard, or through a combination of these modes, and can be provided by researchers, supervisors, or colleagues.

How do you think peer-to-peer feedback impacts the quality of patient care?