MDs want to compare themselves to others
MDs want to compare themselves to others
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"As physicians, we respond to data. That is a very powerful way to convey performance against expectations," says David A. Snyder, MD, vice president of patient care quality and safety at MCG Health in Augusta, GA. "It's good for me to know how I am comparing with last year, but it's even better to know how I am doing against the pack."
Physicians are becoming more hungry for their own quality data, in light of the fact that more data are being publicly reported. "The quality professional is in a perfect position right now to be particularly useful," says Snyder. "When I gave grand rounds to the surgery department, what they wanted me to talk about was emerging trends in outcomes and how they affect individual physicians."
Presenting comparative rankings at the aggregate level is "a great motivator," says Kevin Tabb, MD, chief quality and medical information officer at Stanford (CA) Hospital & Clinics. Show how your institution does compared to its peers — other academic medical centers around the country, for instance — or how a given department or division is ranked in terms of outcomes.
"And in some cases where there is an agreement by the clinicians within a given division, showing how an individual clinician ranks against his or her peers has been effective," says Tabb.
Don't attribute to the wrong service
It's extremely important to present reports and data at the aggregate institutional level, the department or division level and the individual physician level, back to the individual clinicians, says Tabb. However, he notes that appropriate attribution to the right service is "always an issue of discussion."
It's easier to attribute a complication or an outcome in aggregate to the institution. It's more difficult to attribute the complication to a specific division, or in some cases, a surgical subspeciality, and even more difficult to attribute it to an individual physician.
"It may be that a complication occurs for a patient, and in the billing system there is a single name of an attending physician who is the physician of record," says Tabb. However, that physician may have only seen the patient once in two or three weeks, and there was actually an entire team of physicians involved in the patient's care.
"So is it useful to attribute some kinds of complications to individual physicians? That question remains open," says Tabb. "On the other hand, it's quite clear that the complication that occurred at the institution on the aggregate level is of great importance to us."
"As physicians, we respond to data. That is a very powerful way to convey performance against expectations," says David A. Snyder, MD, vice president of patient care quality and safety at MCG Health in Augusta, GA.Subscribe Now for Access
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