Delayed Feedback of Physician Performance Versus Immediate Reminders to Perform Preventive Care: Effects on Physician Compliance

Tierney, William M.; Hui, Siu L.; McDonald, Clement J.

doi:10.1097/00005650-198608000-00001

Cited by 337Primary Care and Health OutcomesClinical Reasoning and Diagnostic SkillsClinical practice guidelines implementation

Delayed Feedback of Physician Performance Versus Immediate Reminders to Perform Preventive Care: Effects on Physician Compliance

Tierney, William M., Hui, Siu L., McDonald, Clement J.·1986·Medical Care

DOI 10.1097/00005650-198608000-00001

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Abstract

In an academic general medicine clinic, we performed a randomized, controlled trial to compare (1) the effects of supplying monthly feedback reports of compliance with preventive care protocols by 135 internal medicine house staff with (2) the effects of specific reminders given to them at the time of patient visits. The protocols were randomly divided into two groups, A and B, and half the house staff were given feedback for Group A and half for Group B. Thus, each group served as a control for the other. Each feedback group was also randomly assigned to receive reminders for either Group A or B protocols. House staff receiving feedback more often complied with fecal occult blood testing, mammography, pneumococcal vaccination, use of metronidazole, and combined Group A and B protocols than did controls (P less than 0.01). There was also significantly more compliance with the same protocols by house staff receiving reminders, but the increase for fecal occult blood testing, pneumococcal vaccination, and combined Group A protocols was twice that seen in physicians given feedback alone. In addition, reminders alone increased compliance with oral calcium supplementation. Overall compliance with the preventive care protocols was low: 10-15% in physicians receiving neither feedback nor reminders, increasing to 15-30% in those receiving reminders. Physician compliance with suggested preventive care protocols can be increased by both delayed feedback and immediate reminders, but reminders have a greater effect.

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Tierney 1986 found that reminders together with audit and feedback were more effective than feedback alone for provision of preventive services by internal medicine trainees (unadjusted RD = 8.0%; no P value reported).
“Tierney 1986 in a complex factorial trial with active controls found that reminders together with audit and feedback were more effective than feedback alone for provision of preventive services by internal medicine trainees (unadjusted RD = 8.0%; no P value reported).”
From Audit and feedback: effects on professional practice and healthcare outcomes (2012) · cites this paper as Tierney 1986

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Authors: Tierney, W. M., Hui, S. L., & McDonald, C. J.
Affiliations: Regenstrief Institute (US)
Corresponding author: Tierney, William M.
McDonald, Clement J.
ORCID: Tierney, William M.
McDonald, Clement J.
Venue: Medical Care
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1986-08
Volume: 24
Issue: 8
Pages: 659-666
ISSN: 0025-7079 (ISSN-L)
DOI: 10.1097/00005650-198608000-00001
OpenAlex: W2006363447
Cited by: 337
References: 19
Citations by year: 2025: 2 · 2024: 4 · 2023: 1 · 2022: 2 · 2020: 6 · 2019: 1 · 2018: 4 · 2017: 3 · 2016: 4 · 2015: 6 · 2014: 3 · 2013: 6 · 2012: 5
FWCI: 31.09
Type: journal article
Language: en
Open access: closed
Locations: Medical Care (publishedVersion)
PubMed (publishedVersion)
Funders: Agency for Healthcare Research and Quality (HS-04080, HS-04996)
Topics: Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords: preventive medicine, physician performance feedback, clinical reminders, fecal occult blood test, mammography, pneumococcal vaccination, metronidazole, oral calcium supplementation, quality improvement
MeSH terms: Clinical Competence, Computers, Feedback, Hospitals, General, Humans, Indiana, Medical Staff, Hospital, Outpatient Clinics, Hospital, Preventive Health Services, Random Allocation

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Delayed Feedback of Physician Performance Versus Immediate Reminders to Perform Preventive Care: Effects on Physician Compliance

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