Performance Feedback in Health Care
Performance Feedback in Health Care
The Southeast Permanente Medical Group (TSPMG) at Kaiser Permanente Georgia provides
 performance feedback to its providers. The performance feedback designs can vary and change
 over time in terms of targets, summary statistics, included measures, and frequency of
 delivery. The TSPMG health services research group seek to compare different performance
 feedback designs to identify which are most effective at contributing to performance
 improvement.

 The research team will randomly assign providers into different performance feedback
 conditions, as specified in the protocol. Providers will receive performance feedback through
 the standard mechanism in which it is conveyed by their supervisor.

 The objective is to investigate how to design performance feedback for providers to best
 motivate and support them in improving performance along with existing strategic priorities
 for care delivery.

 The reserach team will test alternative designs of performance feedback that vary on the
 following dimension:

 1) targets for comparison of one's own performance
The Southeast Permanente Medical Group (TSPMG) provides performance feedback to its
 providers. The performance feedback designs can vary and change over time in terms of
 targets, summary statistics, included measures, and frequency of delivery. The TSPMG health
 services research team will seek to compare different performance feedback designs to
 identify which are most effective at contributing to performance improvement. .

 The research team will randomly assign providers into different performance feedback
 conditions, as specified in the protocol. Providers will receive performance feedback through
 the standard mechanism in which it is conveyed by their supervisor.

 The objective is to investigate how to design performance feedback for providers to best
 motivate and support them in improving performance along with existing strategic priorities
 for care delivery.

 The research team will test alternative designs of performance feedback that vary on the
 following dimension:

 1) targets for comparison of one's own performance

 The research team will provide feedback on performance by measures that the organization
 already tracks internally and uses for performance improvement. These include a provider's
 utilization of opportunities to provide flu vaccinations.

 The study will randomly assign different designs of feedback to providers. In order to
 understand which designs of feedback have the best effects on performance, the research team
 will test the following hypotheses:

 1. Displaying the next-highest quartile will motivate improvement more than display of all
 quartiles.

 Theory: The next-highest quartile will serve as an injunctive norm, or suggested target,
 to repeatedly lift an individual's performance to the suggested level.

 2. The positive effect of displaying the next-highest quartile, relative to displaying all
 quartiles, will be most pronounced for initially low performers.

 Theory: The next highest quartile averts upward social comparison to a much higher level
 of peer performance, which can be discouraging and so negatively affect performance

 3. The positive effect of displaying the next-highest quartile, relative to displaying all
 quartiles, will diminish over time.

 Theory: Individuals may become worn out as they see a target ratchet higher when their
 performance improves.

 4. Displaying team relative performance along with individual relative performance will be
 more effective than displaying either type of information alone.
Inclusion Criteria:

 A healthcare provider practicing at The Southeast Permanente Medical Group in a specialty
 for which the performance measure being studied is relevant.

 Health care providers include:

 Physicians, Nurse Practitioner, Certified Nurse Midwife, Psych Nurse Specialist,
 Optometrist, Podiatrist, and Physician Assistant

 Exclusion Criteria:

 Non-Physicians: Registered Nurses excluding nurse practitioners