Skip to main content

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
  1. Note: 2012 performance categories differ from 2008 because 2012 performance forms a continuum rather than discreet categories (see Fig. 1 and main text for details)