Evidence map›Paper›PMID 35477679›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie

Leveraging financial incentives and behavioural economics to engage physicians in achieving quality-improvement process measures.

Husein Moloo, Tyler Lamb, Sudhir Sundaresan, Kednapa Thavorn, Caolan Walsh, Reilly Musselman, Alan Forster

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.6field-weighted citation impact, top 30% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Husein MolooFrom the Division of General Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Moloo, Lamb, Walsh, Musselman); the The Ottawa Hospital Research Institute, Ottawa, Ont. (Moloo, Thavorn, Musselman, Forster); the School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lamb, Thavorn); the Division of Thoracic Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Sundaresan); and the Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Forster) hmoloo@toh.ca.
Tyler LambFrom the Division of General Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Moloo, Lamb, Walsh, Musselman); the The Ottawa Hospital Research Institute, Ottawa, Ont. (Moloo, Thavorn, Musselman, Forster); the School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lamb, Thavorn); the Division of Thoracic Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Sundaresan); and the Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Forster).
Sudhir SundaresanFrom the Division of General Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Moloo, Lamb, Walsh, Musselman); the The Ottawa Hospital Research Institute, Ottawa, Ont. (Moloo, Thavorn, Musselman, Forster); the School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lamb, Thavorn); the Division of Thoracic Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Sundaresan); and the Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Forster).
Kednapa ThavornFrom the Division of General Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Moloo, Lamb, Walsh, Musselman); the The Ottawa Hospital Research Institute, Ottawa, Ont. (Moloo, Thavorn, Musselman, Forster); the School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lamb, Thavorn); the Division of Thoracic Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Sundaresan); and the Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Forster).
Caolan WalshFrom the Division of General Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Moloo, Lamb, Walsh, Musselman); the The Ottawa Hospital Research Institute, Ottawa, Ont. (Moloo, Thavorn, Musselman, Forster); the School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lamb, Thavorn); the Division of Thoracic Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Sundaresan); and the Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Forster).
Reilly MusselmanFrom the Division of General Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Moloo, Lamb, Walsh, Musselman); the The Ottawa Hospital Research Institute, Ottawa, Ont. (Moloo, Thavorn, Musselman, Forster); the School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lamb, Thavorn); the Division of Thoracic Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Sundaresan); and the Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Forster).
Alan ForsterFrom the Division of General Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Moloo, Lamb, Walsh, Musselman); the The Ottawa Hospital Research Institute, Ottawa, Ont. (Moloo, Thavorn, Musselman, Forster); the School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Lamb, Thavorn); the Division of Thoracic Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Sundaresan); and the Department of Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ont. (Forster).
University of Ottawa · CAOttawa Hospital · CAOttawa Hospital Research Institute

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDedicated quality-improvement (QI) initiatives within health care systems are of clear benefit, and physicians respond to financial incentivization. The Canadian health care system often lacks this lever, and many financially incentivized QI programs rely on traditional economic principles. We describe our evaluation of financial incentivization for the implementation of QI process metrics in a department of surgery at a Canadian academic hospital system and its impact over a 4-year period.

methodsQuality-improvement processes informed by extant QI incentivization literature and guided by the principles of behavioural economics were implemented within our institution's Department of Surgery. Disbursement of supplemental government funding was modified to be contingent on the ability of divisions within the department to meet predefined QI metrics, including regular multidisciplinary meetings, morbidity and mortality rounds with documented feedback of systemic issues to division members, reviews of adverse events, and implementation of annual patient experience projects. We evaluated the effect of the QI processes from 2015/16 to 2018/19.

resultsThere was a significant increase in the number of divisions that satisfied all the QI metrics over the study period, from 2 (28%) in 2015/16, to 5 (71%) in 2016/17, to 7 (100.0%) in 2017/18 and 2018/19 (

conclusionIncentivizing QI activities in the Canadian health care system is possible and led to improvement in QI processes as a whole in our department. This paper lays out a method of financial reimbursement to facilitate engagement of physicians and establishment of a foundation of important QI processes and measures within a department.

Indexed as

PhysiciansProcess Assessment, Health CareCanadaEconomics, BehavioralHumansMotivation

Identifiers

PMID35477679
PMCPMC9188803
OpenAlexW4225102712

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.