Introduction
In an effort to improve clinical care and provide more quantitative feedback to clinicians, the practice of audit and feedback (A&F) has been implemented as a quality improvement (QI) initiative in many clinical practice settings1. Systematic reviews have demonstrated that the net effect of these interventions on overall performance is small1 and that implementation for selected measures is done ineffectively2. While the literature on the implementation of best practices for A&F measures is increasing3, the endpoints of clinical practice change for end-users (physicians) is rarely assessed.
At present, there is very little guidance on how to use a refined A&F tool that has been well implemented to the minds, hearts and behaviors of physicians working in the clinical space. In other words, how do we take what is known in the field of A&F and translate this into meaningful practice change for practitioners? Many fields are currently asking the same question. The proliferation of discussions around clinical coaching4, expanded continuing professional development (CPD) curricula, the inclusion of design thinking modalities and the creation of peer learning spaces5–8 are all indicative of a variety of “specialties” looking to answer the same question.
In response, we sought to develop an understanding of how physicians experienced the act of receiving practice data and develop a model that describes how individuals may interact with the practice data that they receive. Such a model would guide a series of different interventions across a variety of data and ”readiness to change” environments. It may also provide insights on how best to design data systems and how to approach clinicians for change improvement within different data and change contexts.