Physician feedback is typically sporadic after residency training is completed. The literature suggests that feedback given in letter form or only for poor performance is ineffective in changing physician behavior and can lead to job dissatisfaction.
To implement a feedback paradigm that engages and motivates physicians with the goal of affecting future performance.
Individualized feedback sessions were conducted at a large, urban academic medical center between hospitalists and the program director to discuss performance. Metrics were chosen based on organizational and departmental goals including length of stay, billing/coding practices, productivity, primary care provider communication, and teaching evaluations. Physicians were compared with peers through deidentified graphs. Provider charts were also reviewed for Joint Commission compliance and audited for individual clinical practice patterns. Each hospitalist had an opportunity to discuss personal goals and share his or her own feedback. Before the session concluded, each hospitalist determined targeted areas of improvement, and a “contract” between the physician and program director was signed. After all meetings were complete, the physicians were sent an anonymous survey in order to assess their perceptions of the process and utility of this feedback paradigm. The results showed that 18 of the 19 physicians who took part in the sessions completed a survey regarding their perception of the meeting. Physicians had from 1 to 11 years of hospitalist experience and included institutional leaders in patient safety and academic medicine who are also part of the hospitalist group. Responses were universally positive, regardless of individual performance, years of experience, or role in the institution. One hundred percent of respondents reported a better understanding of evaluation metrics after the completion of the session. Seventy‐two percent described the session as “useful” and ranked billing/coding feedback among the most valuable. All respondents reported that comparison with their peers was either a “helpful” or “motivational” form of evaluation. Seventy‐two percent said the session would likely impact future performance. The majority of physicians reported that signing a contract would help them focus on targeted improvement areas. One hundred percent of respondents reported feeling “engaged” or “fully engaged” with the hospitalist group.
Feedback is critical and likely underutilized in hospitalist groups. Providing face‐to‐face feedback from respected leadership enables physicians to understand their own performance and its impact. It allows the leadership to formalize expectations and gives an opportunity for education and recognition. It allows opinions to be heard and dealt with directly, which can improve satisfaction. Feedback sessions done in this manner were universally well received and believed to have value in motivating positive change. This model is transportable to other groups and will be further developed at our institution.
D. Rizk ‐ none; A. Nussbaum ‐ none