Public Performance Metrics: Driving Physician Motivation and Performance.

Introduction: As providers transition from “fee-for-service” to “pay-for-performance” models, focus has shifted to improving performance. This trend extends to the emergency department (ED) where visits continue to increase across the United States. Our objective was to determine whether displaying...

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Publicado en:Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Vol. 21; no. 2; pp. 247 - 252
Autores principales: Jen, Maxwell Y., Han, Vy, Bennett, Kathryn, Rudkin, Scott E., Wong, Andrew C., Barton, Erik D., Goubert, Ronald
Formato: research tables/charts Journal Article
Publicado: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Mar2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
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        atl: Public Performance Metrics: Driving Physician Motivation and Performance.
      aug:
        au:
          Jen, Maxwell Y.
          Han, Vy
          Bennett, Kathryn
          Rudkin, Scott E.
          Wong, Andrew C.
          Barton, Erik D.
          Goubert, Ronald
        affil: University of California Irvine, Department of Emergency Medicine, Orange, California.
      sug:
        subj:
          Job Performance
          Triage
          Physicians, Emergency
          Motivation
          Task Performance and Analysis
          Reimbursement, Incentive
          Human
          United States
          Academic Medical Centers
          Retrospective Design
          Record Review
          Descriptive Statistics
          Emergency Service
          Shiftwork
      ab: Introduction: As providers transition from “fee-for-service” to “pay-for-performance” models, focus has shifted to improving performance. This trend extends to the emergency department (ED) where visits continue to increase across the United States. Our objective was to determine whether displaying public performance metrics of physician triage data could drive intangible motivators and improve triage performance in the ED. Methods: This is a single institution, time-series performance study on a physician-in-triage system. Individual physician baseline metrics—number of patients triaged and dispositioned per shift—were obtained and prominently displayed with identifiable labels during each quarterly physician group meeting. Physicians were informed that metrics would be collected and displayed quarterly and that there would be no bonuses, punishments, or required training; physicians were essentially free to do as they wished. It was made explicit that the goal was to increase the number triaged, and while the number dispositioned would also be displayed, it would not be a focus, thereby acting as this study’s control. At the end of one year, we analyzed metrics. Results: The group’s average number of patients triaged per shift were as follows: Q1-29.2; Q2-31.9; Q3-34.4; Q4-36.5 (Q1 vs Q4, p < 0.00001). The average numbers of patients dispositioned per shift were Q1-16.4; Q2-17.8; Q3-16.9; Q4-15.3 (Q1 vs Q4, p = 0.14). The top 25% of Q1 performers increased their average numbers triaged from Q1-36.5 to Q4-40.3 (ie, a statistically insignificant increase of 3.8 patients per shift [p = 0.07]). The bottom 25% of Q1 performers, on the other hand, increased their averages from Q1-22.4 to Q4-34.5 (ie, a statistically significant increase of 12.2 patients per shift [p = 0.0013]). Conclusion: Public performance metrics can drive intangible motivators (eg, purpose, mastery, and peer pressure), which can be an effective, low-cost strategy to improve individual performance, achieve institutional goals, and thrive in the pay-for-performance era.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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