ArticleCanadian family physician Medecin de famille canadien2014
"My approach to this job is...one person at a time": Perceived discordance between population-level quality targets and patient-centred care.
Article in Canadian family physician Medecin de famille canadien, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- An exploration into physician and surgeon data sensemaking: a qualitative systematic review using thematic synthesis.BMC medical informatics and decision making · 2022Pooled it
- Systematic review and narrative synthesis of computerized audit and feedback systems in healthcare.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Clinical Performance Feedback Intervention Theory (CP-FIT): a new theory for designing, implementing, and evaluating feedback in health care based on a systematic review and meta-synthesis of qualitative research.Implementation science : IS · 2019Pooled it
- A systematic review of electronic audit and feedback: intervention effectiveness and use of behaviour change theory.Implementation science : IS · 2017Pooled it
- Mailed feedback to primary care physicians on antibiotic prescribing for patients aged 65 years and older: pragmatic, factorial randomised controlled trial.BMJ (Clinical research ed.) · 2024Trial
- Effect of a web-based audit and feedback intervention with outreach visits on the clinical performance of multidisciplinary teams: a cluster-randomized trial in cardiac rehabilitation.Implementation science : IS · 2016Trial
- Improving stroke prevention therapy for patients with atrial fibrillation in primary care: protocol for a pragmatic, cluster-randomized trial.Implementation science : IS · 2016Trial
- Trial
- Improving guideline concordance in multidisciplinary teams: preliminary results of a cluster-randomized trial evaluating the effect of a web-based audit and feedback intervention with outreach visits.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2015Trial
- Feedback GAP: pragmatic, cluster-randomized trial of goal setting and action plans to increase the effectiveness of audit and feedback interventions in primary care.Implementation science : IS · 2013Trial
- Implementing a digital audit-and-feedback surveillance system for diabetic ketoacidosis: study protocol for the DEKODE programme.Frontiers in health services · 2026Article
- The engagement equation: a model for understanding what drives voluntary physician engagement with data-driven clinical performance feedback.Implementation science communications · 2025Article
- Implementation and acceptability of the Caregiver Care Model in general practice: a mixed-method feasibility study.BMC primary care · 2025Article
- Utilisation of a cocreation methodology to develop claims-based indicators for feedback on implementation of comparative effectiveness research results into practice.BMJ open quality · 2025Article
- Audit and group feedback in nursing home physician groups: lessons learned from a qualitative study.BMC health services research · 2025Article
- Do medical specialists accept claims-based Audit and Feedback for quality improvement? A focus group study.BMJ open · 2024Article
- Best practice guidance for antibiotic audit and feedback interventions in primary care: a modified Delphi study from the Joint Programming Initiative on Antimicrobial resistance: Primary Care Antibiotic Audit and Feedback Network (JPIAMR-PAAN).Antimicrobial resistance and infection control · 2023Article
- Snakes and ladders: A qualitative study understanding the active ingredients of social interaction around the use of audit and feedback.Translational behavioral medicine · 2023Article
- Characterizing the Gaps Between Best-Practice Implementation Strategies and Real-world Implementation: Qualitative Study Among Family Physicians Who Engaged With Audit and Feedback Reports.JMIR human factors · 2023Article
- 'Give me something meaningful': GPs perspectives on how to improve an audit and feedback report provided by health insurers - an exploratory qualitative study.BMJ open quality · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveTo understand the usefulness of audit and feedback among family physicians and examine the barriers to using it to improve quality of care.
designQualitative study using in-depth interviews.
settingFamily physicians across Ontario participating in audit and feedback initiatives describing the proportion of patients meeting quality targets for chronic disease.
participantsPurposive sampling was conducted to ensure variation in sex, years of experience, and baseline performance for quality metrics. All participants used electronic medical records and worked in multidisciplinary primary care practices.
methodsSemistructured interviews were conducted with family physicians. The interview guide and initial coding framework were adjusted iteratively in keeping with the constant comparative method. Sampling continued until saturation was reached. Interviews were analyzed using the framework approach. MAIN
findingsParticipants reported that the feedback increased their awareness of gaps between ideal and actual performance. This resulted mainly in efforts to "try harder" patient by patient. Key barriers to acting upon feedback in a systematic manner included a perceived discordance between population-level quality targets and patient-centred care, as well as competing priorities at both the patient and organizational levels. Although all participants had electronic medical records, participants reported a lack of quality improvement infrastructure in their practices.
conclusionFamily physicians were not highly motivated to achieve evidence-based population-level quality targets for diabetes; many competing organizational and clinical goals took priority. Additional human resources might be needed to translate data in feedback reports into systematic changes that could lead to sustained improvements in quality of care.
Indexed as
Identifiers
24627384PMC3952764What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.