Confidential Performance Feedback and Organizational Capacity Building to Improve Hospital Patient Safety: Results of a Randomized Trial

Excerpt

Objective: The objective of this study was to evaluate the effect of two intervention strategies, performance feedback reporting and organizational capacity building, both of which aim to improve patient safety in hospitals but for which there is a paucity of empirical data on effectiveness. Methods: We randomly assigned the 127 non-Federal, acute care hospitals in Wisconsin to one of three groups: (1) performance feedback reporting, (2) performance feedback reporting and organizational capacity building, and (3) control (no interventions). Reported medical injury rates were based on the Wisconsin Medical Injury Prevention Program (WMIPP) surveillance criteria. We compared adjusted pre- and postintervention injury rates overall, in four broad categories, and for five priority areas targeted in the organizational capacity building. Results: The groups of hospitals were similar with respect to location, structure, inpatient utilization, facilities, and services offered. Overall medical injury rates for drug-associated injuries increased significantly during the study period in all groups. No statistically significant differences among the intervention groups or between either of the intervention groups and the control group were detected for overall injury or any of the five major category injury rates. Conclusion: The inability to demonstrate a reduction in medical injury rates in relation to either confidential performance feedback reporting or organizational capacity building may be due to either methodologic limitations of the study or ineffectiveness of the interventions.