Table 3 Summary of sites’ mental models and degree of positivity, intensity, and consistency
From: Mental models of audit and feedback in primary care settings
Performance category (2007–2008) | Site | Performance category (2011–2012) | Mental model summary | Sign/theme | Intensity | Consistency |
|---|---|---|---|---|---|---|
High performers | B | Moderate | Aim: EPRP feedback is communicated, tracked, and improved upon in a ubiquitous, transparent, non-punitive, systematic, and consistent way. | Positive: transparency | Medium | High |
H | High | EPRP as a benchmark or model for the best standards of care for keeping the whole patient as healthy as possible. | Positive: benchmarking | Medium | Low | |
M | Moderately high | EPRP measures are generally OK, but not sophisticated enough to be reflect actual care quality | Negative: EPRP not a good representation of quality | Medium | High | |
Consistently moderate | D | Moderate | EPRP serves as a primary means of linking the work/efforts of all facility staff to the facility’s mission: to provide the best quality of care that veterans expect and deserve | Positive: strategic alignment | Medium | Medium |
K | Moderate | EPRP is not a real true reflection of the quality of one’s practice because of the sample size at a particular time period. | Negative: EPRP not a good representation of quality | Medium | Medium | |
E | Moderately high | Clinicians think EPRP is inferior to their population-based, VISN created dashboard, and leaders have concerns about overuse and misinterpretations or misuse of EPRP | Negative: EPRP not a good representation of quality | Medium | Medium | |
Highly variable | A | Low | EPRP remains relevant as a starting point for setting, aligning, and monitoring clinical performance goals | Positive: strategic alignment | Medium | High |
G | Moderately low | EPRP as an “outside checks and balance” system that validates whether or not how the facility thinks they are doing (e.g., good job) and what challenge areas they have are accurate, however, there are no real or punitive consequences to scoring low. | Mixed | Medium | Medium | |
L | Low | Although EPRP does not reflect actual care quality, the numbers indicate that they are doing something consistently right that helps their patients | Mixed | Low | High | |
Low performers | F | Moderate | Immediate feedback is advantageous to memory, but not always well received. | Negative: EPRP has made us hyper-vigilant | High | Medium |
C | Low | EPRP is viewed by some as an objective, unbiased measure with some sampling limitations; by others, EPRP is viewed as inaccurate or retrospective | Negative: EPRP not a good representation of quality | Medium | Low | |
J | Low | Site struggles to provide feedback; clinicians did not receive EPRP and PMs until the PACT implementation. | No feedback until PACT | Low | Medium |