Table 2.
MFS Characteristics.
| Study | Goal | Data Source | Unit of Analysis | Content of Feedback |
Feedback Delivery |
Feedback Recipients |
Action Facilitation |
Co-Interventions |
|---|---|---|---|---|---|---|---|---|
| Banerjee et al. (2017) [48], United States | Reduce heart failure re-admissions | EMR (Epic Systems Corporation) + patient satisfaction data | Individual provider | Quality indicators (i.e., readmission rates for HF) | Interactive dashboard updated daily with drill-down options | Cardiology MDT | NR | New model of care |
| Cline et al. (2016) [39], United States | Improve adherence to pain management guidelines | EMR | Unit level | Quality indicators (i.e., rates of pain assessment) | Monthly emailed report | Nurses | Coaching, annual review | Education session |
| Corson et al. (2015) [46], Sweden | Reduce unnecessary test-ordering | EMR | Individual provider | A list of providers/no. of common labs ordered, case study examples | Monthly emailed report | Hospitalist providers | Academic detailing session | NR |
| Dowling et al. (2022) [38], Canada | Reduce low-value bronchiolitis management | EMR + national ambulatory care dataset | Individual provider (w/peer comparison) | Quality indicators (i.e., length of stay, ED revisits within 72 h) | Two data reports | Pediatric ED clinicians | Team feedback sessions, a commitment to change form (action planning) | NR |
| Hester et al. (2019) [37], United States | Reduce low-value bronchiolitis management | EMR (Cerner Corporation) | Individual with specific patient cohorts (w/peer comparison), and unit level | Quality indicators (i.e., use of chest radiographs, bronchodilators) | Interactive dashboard with drill-down options (voluntary dashboard use) | Pediatric ED clinicians | NR | Education and guideline disseminated prior to intervention, EMR order-set implemented 2 months into intervention |
| Kestenbaum et al. (2019) [40], United States | Improve pain management for patients with advance illness and unnecessary prescribing | EMR | Individual provider (w/peer comparison) and hospital level | Aggregated patient pain scores in each service region, prescribing patterns of eight medications | Monthly hand- delivered report | Palliative care clinicians | Report delivered by Chief of Medical Staff | Education session, information hand-outs, and implementation of a Preferred Drug List |
| Larkin et al. (2021) [45], United States | Improve ED physician Computed tomography (CT) ordering behavior | EMR (Epic) | Individual provider (w/peer comparison) | Quality indicator (i.e., CT ordering rate) | Graphical report | ED physicians | Review session with a research assistant | Education session |
| Navar-Boggan et al. (2014) [50], United States | Improve blood pressure control | EMR | Individual (w/peer comparison) | Quality indicator (i.e., blood pressure control, stage II hypertension) | Quarterly emailed report | Cardiologists | NR | Unspecified ongoing quality improvement initiatives |
| Parks et al. (2021) [49], United States | Improve adherence with intra-operative lung-protective ventilation (LPV) | EMR + anesthesia dataset | Individual provider (w/peer comparison) | Quality indicator (i.e., adherence to LPV protocol) | Interactive dashboard | Anesthetists | NR | Phased implementation: education, clinical decision support |
| Patel et al. (2018) [44], United States | Improve quality of discharge | EMR (Epic) | Team level | 6 quality indicators (i.e., phlebotomy use, medication reconciliation) | Interactive dashboard updated daily (QlikView) | Internal medicine teams | Weekly team review of data facilitated by lead clinician | Education session |
| Riblet et al. (2014) [52], United States | Increase number of patients meeting the standards of care for glioma care | EMR + existing quality improvement database | Team level | 10 quality indicators on peri-operative care (i.e., appropriate use of corticosteroids) | Interactive dashboard | Neuro-oncology MDTs | Quarterly team meetings led by process owners for each measure and statistician support | EMR modified to improve interdisciplinary communication, pharmacy order set, and discharge summary sent to the MDT implemented prior to intervention |
| Riblet et al. (2016) [51] (Phase 2 of Riblet et al. 2016) | Additional 12 quality indicators focused on acute care (i.e., post-operative complications) | New clinical pathway implemented | ||||||
| Trent et al. (2019) [47], United States | Improve adherence to a sepsis/pneumonia guidelines | EMR + existing quality improvement database | Individual provider (w/peer comparison) and institution level | Composite quality indicator (adherence to guidelines) | Monthly emailed report + additional emailed list of patients who received nonadherent care | ED physicians | NR | New sepsis bundle package & antibiotic implemented prior to intervention |
| Stevens et al. (2017) [53], United States | Reduce prescription of potentially inappropriate medications (PIMs) for older adults during ED discharge | EMR (Epic) | Individual provider (w/peer comparison) | Quality indicators (i.e., no. of patients >65 evaluated, PIM rate) | Monthly emailed report + one face to face academic detailing session | ED physicians | NR | Clinical decision support tool, pharmacy order sets, online education |
| Vaughan et al. (2021) [42], (Phase 2 of Stevens et al. 2017) | Quality indicators (i.e., 30-day PIM rate) | Interactive dashboard | Attending physicians and residents | Academic detailing | Education sessions led by local champions, pharmacy order sets | |||
| Wang et al. (2021) [43], United States | Improve adherence to opioid pre- scribing guidelines for the treatment of chronic non cancer-associated pain | EMR (Epic) | Individual provider (w/peer comparison) and institution level | Quality indicators (i.e., % of patients with an active opioid agreement) | Interactive dashboard (users able to create lists of patients with non-adherent care) | Rheumatologists | Initial team meeting to establish goals, action plan, divisional leadership provided coaching for prescribers who were not improving | Education session using baseline data, modified EMR to integrate local drug monitoring database/improve workflow |