74. Flipping the Narrative on Performance Metrics | Why we're bad at self assessment, crafting meaningful metrics, balancing data
Mar 21, 2022
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Dr. Shawn Dowling, medical director of The Physician Learning Program at the University of Calgary, discusses the reframing of performance metrics to improve provider experience. Topics include: self-assessment challenges, clinician-relevant metrics, presenting metrics to providers, and high-yield metrics that make a difference.
Metrics can be reframed to be more meaningful and less punitive, involving physicians in co-designing them.
Feedback and audit sessions are crucial in improving metrics, promoting self-reflection and action planning.
Deep dives
Importance of Performance Metrics
In this episode, Dr. Sean Dowling discusses the importance of performance metrics in healthcare. He emphasizes the need for physicians to have a good understanding of how they practice and how it compares to their colleagues. By providing physicians with dynamic feedback on their practice, they can identify both perceived and unperceived learning needs. Dr. Dowling highlights the need to redesign and co-design metrics with physicians to make them meaningful and reflective of what they want to achieve in patient care.
The Challenge of Metrics in Medicine
Metrics in medicine have often been seen as punitive and not well thought out. However, Dr. Dowling argues that despite the negative impact of metrics in the past, they can be redesigned to be more effective. He explains that rather than eliminating metrics altogether, they should be crafted in a way that reflects what physicians value and can lead to improvements in quality of care. Dr. Dowling suggests that feedback and discussions with clinicians, involving them in co-designing metrics, can help create a more meaningful and less punitive approach.
The Role of Feedback and Audit in Metrics
Dr. Dowling emphasizes the role of feedback and audit in improving metrics. He explains that providing physicians with real-time data and facilitating audit feedback sessions can be highly impactful. These sessions involve clinicians presenting their own data and discussing it with their peers. By normalizing reactions to data and focusing on self-reflection rather than punishment, physicians can identify areas for improvement and develop action plans. Dr. Dowling also highlights the importance of creating balancing metrics to provide a more comprehensive view of patient care.
Challenges and Opportunities in Metric Implementation
Dr. Dowling acknowledges the challenges in implementing metrics, such as limited measurement options and the lack of meaningful and actionable data. However, he suggests that metrics can be used as tools to guide change and improvement. He advocates for moving away from a purely punitive approach and involving physicians in the decision-making process. Dr. Dowling also emphasizes the need to consider system-level changes and patient expectations in designing metrics. Overall, he encourages clinicians to embrace metrics as an opportunity for self-reflection and quality improvement.
It doesn’t look like performance metrics are going away any time soon. So why not make them a feature instead of a bug? We discuss: reframing audits so they help elevate and don't feel punitive, why we're not good at self-assessment, creating clinician-relevant (and friendly) metrics, the best way to present metrics to providers, 3 high-yield metrics that make a difference.
Guest Bio: Shawn Dowling MD is the medical director of The Physician Learning Program at the University of Calgary and Clinical Content Lead at the Calgary Zone Emergency Department.
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