Reporting feedback on healthcare outcomes to improve quality in care: a scoping review

BACKGROUND: Providing healthcare providers (HCPs) feedback on their practice patterns and achieved outcomes is a mild to moderately effective strategy for improving healthcare quality. Best practices for providing feedback have been proposed. However, it is unknown how these strategies are implemented in practice and what their real-world effectiveness is. This scoping review addresses this gap by examining the use and reported impact of feedback reporting practices in various clinical fields.

METHODS: A systematic review of the literature was conducted, and electronic databases were searched for publications in English between 2010-June 2024. We included studies that utilized and evaluated feedback reporting to change HCP behaviours and enhance outcomes, using either qualitative or quantitative designs. Two researchers reviewed and extracted data from full texts of eligible studies, including information on study objectives, types of quality indicators, sources of data, types of feedback reporting practices, and co-interventions implemented.

RESULTS: In 279 included studies we found that most studies implemented best practices in reporting feedback, including peer comparisons (66%), active delivery of feedback (65%), timely feedback (56%), feedback specific to HCPs' practice (37%), and reporting feedback in group settings (27%). The majority (68%) combined feedback with co-interventions, such as education, post-feedback consultations, reminders, action toolboxes, social influence, and incentives. 81% showed improvement in quality indicators associated with feedback interventions. Interventions targeting outcome measures were reported as less successful than those targeting process measures, or both. Feedback interventions appeared to be more successful when supplemented with post-feedback consultations, reminders, education, and action toolboxes.

CONCLUSION: This review provides a comprehensive overview of strategies used to implement feedback interventions in a wide range of practice settings. Targeting process measures or combining them with outcome measures results in more positive outcomes. Additionally, feedback interventions may be slightly more effective when combined with other interventions designed to facilitate behaviour change. These findings can provide valuable insights for others wishing to implement similar interventions.

REGISTRATION: Open Science Framework, https://doi.org/10.17605/OSF.IO/GAJVS .