Participatory design invites physician engagement in performance dashboard and feedback system

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(OAKBROOK TERRACE, Illinois, February 24, 2022) – Clinician performance feedback is widely used in quality improvement. However, there is a lack of practical guidance describing the process of developing performance feedback systems. 

A new study from the March 2022 issue of The Joint Commission Journal on Quality and Patient Safety, “Using Participatory Design to Engage Physicians in the Development of a Provider-level Performance Dashboard and Feedback System,” details how the University of California, San Francisco used participatory design methodology to develop a performance dashboard and feedback system. 

Participatory design is a methodology that engages and incorporates end-user feedback throughout the design process to ensure the product supports end-user goals, fits organizational context and invites positive attitudes for change. 

Twenty hospitalist physicians participated in a series of six design sessions and two surveys. Each session and survey systematically addressed key components across the continuum of the feedback system, including design, metric selection, data delivery and incentives. The researchers then used the Capability Opportunity Motivation and Behavior (COM-B) model to identify behavior change interventions to facilitate engagement with the dashboard. 

The findings suggest that dashboard and feedback systems developed using participatory design can effectively engage physicians. It also shows that physicians prefer:

• Collaboration over competition
• Internal motivation over external incentives
• Dashboard used to aid clinical practice over punitive uses
• Clinical and patient-centered metrics over financial or throughput metrics 

The study authors recognize that while each health group has distinct needs, the process they described can provide insight and serve as a guide for designing a provider-level feedback system. 

“To improve clinical outcomes, leaders must focus not only on the performance of individuals, but also on that of the infrastructure within which they work, developing feedback loops and interventions aimed at supporting improvements in both,” notes an accompanying editorial by Areeba Y. Kara, MD, MS and Jeffrey M. Rohde, MD.  

Also featured in the March issue:

• Performance of a Commonly Used Pressure Injury Risk Model Under Changing Incidence (Stanford University School of Medicine, California)
• Changes in Rates and Modality of Interpreter Use for Pediatric Emergency Department Patients in the COVID-19 Era (Seattle Children’s Hospital, Washington)
• Improving Antibiotic Stewardship for Inpatients with Reported Beta-Lactam Allergies and Limited Access to Penicillin Skin Testing (New York-Presbyterian/Weill Cornell Medicine, New York)
• Medication Errors in Overweight and Obese Pediatric Patients: A Narrative Review (The Johns Hopkins Hospital, Baltimore)
• Increasing Telehealth Access to Care for Older Adults During the COVID-19 Pandemic at an Academic Medical Center: Video Visits for Elders Project (VVEP) (University of California, San Francisco)
• Hospital at Home: Setting a Regulatory Course to Ensure Safe, High-Quality Care (commentary)

For more information, visit The Joint Commission Journal on Quality and Patient Safety website.  

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Note for Editors

The article is “Using Participatory Design to Engage Physicians in the Development of a Provider-level Performance Dashboard and Feedback System” by Sajan Patel, MD; Logan Pierce, MD; Maggie Jones, MD; Andrew Lai, MD; Michelle Cai, BA; Bradley A. Sharpe, MD; and James D. Harrison, MPH, PhD. The article appears in The Joint Commission Journal on Quality and Patient Safety, volume 48, number 3 (March 2022), published by Elsevier.  

The Joint Commission Journal on Quality and Patient Safety

The Joint Commission Journal on Quality and Patient Safety (JQPS) is a peer-reviewed journal providing health care professionals with innovative thinking, strategies and practices in improving quality and safety in health care. JQPS is the official journal of The Joint Commission and Joint Commission Resources, Inc. Original case studies, program or project reports, reports of new methodologies or the new application of methodologies, research studies, and commentaries on issues and practices are all considered.