Fifty percent of quality improvement studies fail to change medical practices

June 25, 2014

Over the last two decades, nearly half of all initiatives that review and provide feedback to clinicians on healthcare practices show little to no impact on quality of care, according to a new study by Women's College Hospital's Dr. Noah Ivers.

The study, published in the Journal of General Internal Medicine, found only 28 per cent of all studies showed an improvement of at least 10 per cent in quality of care over a 25-year period.

"Research shows there is a gap between recommended practices and the care actually receive," said Dr. Noah Ivers, a family physician at Women's College Hospital and lead author of the study. "While we have a number of studies showing that providing to can act as a foundation for improving quality of care if done properly, we found, in most cases, quality improvement efforts are haphazardly implemented, reinventing the wheel rather than learning from what we already know."

In the study, researchers examined 62 studies in the scientific literature and found feedback on was most effective when:

  • it is delivered by a respected colleague
  • it is repeated multiple times
  • it includes specific goals and action plans, and
  • it focuses on a problem where there was a larger scope for improvement.

When efforts to improve quality of care do not build on lessons learned from previous research, opportunities are wasted to improve outcomes for patients, the researchers said. Just as best evidence should be used to decide which treatment is the right choice for a certain problem, a scientific approach should be taken when figuring out ways to ensure that patients receive the right treatment every time, they add.

"New scientific studies that have tried to get clinicians to more consistently provide the right care for the right patients by providing them with feedback reports of their past performance have contributed little new knowledge on how to best do this so that it results in better outcomes for patients," Dr. Ivers noted. "While we know from previous research that providing clinicians with a specific action plan for improvement is essential for providing better care for patients, feedback initiatives rarely include plans aimed at changing the behavior of healthcare professionals."

Explore further: Quality of care measures improve performance

Related Stories

Quality of care measures improve performance

March 4, 2013
Public reporting of how physicians and hospitals perform in quality of care measures leads to improved care for patients. A collaborative team of researchers led by Geoffrey C. Lamb, M.D., professor of internal medicine at ...

Study finds coordinated approach improves quality of primary care

June 3, 2014
Primary care doctors practicing in a model of coordinated, team-based care that leverages health information technology are more likely to give patients recommended preventive screening and appropriate tests than physicians ...

Doctors reluctant to discuss end-of-life care with heart failure patients

June 4, 2014
Healthcare providers are reluctant to discuss end-of-life care with heart failure patients and their families because they feel uncomfortable broaching the topic or lack time, according to a new study presented at the Quality ...

First survey of ACOs reveals surprising level of physician leadership

June 2, 2014
In spite of early concerns that hospitals' economic strengths would lead them to dominate the formation of Accountable Care Organizations (ACOs), a new study published in the June issue of Health Affairs reveals the central ...

Provider reminder tool can improve screening rates

November 6, 2013
(HealthDay)—A care coordinator and clinical reminder tool can enhance providers' ordering of preventive health screenings, according to a study published in the September/October issue of the Journal for Healthcare Quality.

Expert CLABSI guidance adds real world implementation strategies

June 11, 2014
As central-line associated bloodstream infections (CLABSIs) pose a danger to vulnerable patients, infection prevention and control experts released new practical recommendations to assist acute care hospitals in implementing ...

Recommended for you

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

Safety of medical devices not often evaluated by sex, age, or race

July 25, 2017
Researchers at Yale and the University of California-San Francisco have found that few medical devices are analyzed to consider the influence of their users' sex, age, or race on safety and effectiveness.

Why you should consider more than looks when choosing a fitness tracker

July 25, 2017
A UNSW study of five popular physical activity monitors, including Fitbit and Jawbone models, has found their accuracy differs with the speed of activity, and where they are worn.

Dog walking could be key to ensuring activity in later life

July 24, 2017
A new study has shown that regularly walking a dog boosts levels of physical activity in older people, especially during the winter.

Alcohol to claim 63,000 lives over next five years, experts warn

July 24, 2017
Alcohol consumption will cause 63,000 deaths in England over the next five years – the equivalent of 35 deaths a day – according to a new report from the University of Sheffield Alcohol Research Group.

Alcohol boosts recall of earlier learning

July 24, 2017
Drinking alcohol improves memory for information learned before the drinking episode began, new research suggests.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.