Background: Peer feedback is well-known as a beneficial, low resource tool for enhancing clinical excellence among healthcare professionals.1,2 Anonymous, consistent peer feedback is less likely to be construed as punitive. 3 It allows individuals to learn from mistakes and correct behavior prior to a severe event, 4 as accuracy of self-assessment is generally poor. 2 Despite its well-documented benefits, many hospital medicine programs lack a standardized method for consistently providing and receiving personalized feedback. 1 This results in delayed improvement or potentially sentinel events. In general, among hospital medicine programs, reviews of clinical performance are usually conducted during annual performance reviews after a sentinel event. This can lead to discussions being viewed as punitive as opposed to a learning opportunity. Additionally, an institution-wide survey showed dissatisfaction with the quality of physician handoffs at transitions of care. However, the literature shows that in hospital medicine the optimal time to provide feedback is at transitions of care. 1
Purpose: To develop, implement, and evaluate a standardized method of providing consistent feedback on clinical care with a goal of improving overall communication and clinical care.
Description: In 3/2024, after surveying general medicine hospitalists, we determined there was no standardized feedback method and conducted a root cause analysis. Based on these results, we developed and implemented a novel feedback tool and accompanying EMR smartphrase linked to the tool for all physicians in our division in 8/2024. Use of the tool was expanded in 11/2025 to include divisional advanced practice providers (APPs). To support and encourage participation, at the beginning of service, hospitalists were emailed reminders to provide feedback. To assess the engagement with the tool, the number of individual providers submitting feedback, the total number of feedback responses, and percentage of providers who are submitting feedback were measured. Additionally, follow-up surveys assessing perceived improvement in the feedback process and improvement in quality of handoffs at times of care transitions were conducted with hospitalists. The feedback tool is completed via Qualtrics with responders noting areas of excellence or improvement with potential areas including handoffs, note quality, and other aspects of clinical care on recipients. Responders are encouraged to provide comments for further context for the selected categories.
Conclusions: To date, 176 hospitalists and 45 APPs have been educated on the tool. Since implementation, there has been an average of 4.3 responses per week. Post-implementation, 54% of respondents felt the division had an effective feedback method, compared to 6% pre-implementation. In FY25, there were 200 responses by 56 (34.8%) individuals regarding 103 (64.0%) colleagues. In the first four months of FY26, there have been 71 responses by 28 (17.0%) individuals regarding 54 (32.7%) colleagues. A standardized method for providing feedback can improve satisfaction with the feedback process and allow for improved reflection on clinical care. To address deficits among providers identified by the tool, divisional leadership formed a committee to develop a divisional policy to support the promotion of good clinical practice patterns and develop interventions for those not meeting divisional standards.