A Multifaceted Organizational Physician Assessment Program: Validity Evidence and Implications for the Use of Performance Data.

Autor:	Leep Hunderfund AN; Department of Neurology, Mayo Clinic, Rochester, MN., Park YS; Medical Education, University of Illinois at Chicago., Hafferty FW; Department of General Internal Medicine, Mayo Clinic, Rochester, MN., Nowicki KM; Department of Clinical Ethics, Mayo Clinic, Rochester, MN., Altchuler SI; Department of Psychiatry, Mayo Clinic, Rochester, MN., Reed DA; Department of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN.
Jazyk:	angličtina
Zdroj:	Mayo Clinic proceedings. Innovations, quality & outcomes [Mayo Clin Proc Innov Qual Outcomes] 2017 Jul 25; Vol. 1 (2), pp. 130-140. Date of Electronic Publication: 2017 Jul 25 (Print Publication: 2017).
DOI:	10.1016/j.mayocpiqo.2017.05.005
Abstrakt:	Objective: To provide validity evidence for a multifaceted organizational program for assessing physician performance and evaluate the practical and psychometric consequences of 2 approaches to scoring (mean vs top box scores). Participants and Methods: Participants included physicians with a predominantly outpatient practice in general internal medicine (n=95), neurology (n=99), and psychiatry (n=39) at Mayo Clinic from January 1, 2013, through December 31, 2014. Study measures included hire year, patient complaint and compliment rates, note-signing timeliness, cost per episode of care, and Likert-scaled surveys from patients, learners, and colleagues (scored using mean ratings and top box percentages). Results: Physicians had a mean ± SD of 0.32±1.78 complaints and 0.12±0.76 compliments per 100 outpatient visits. Most notes were signed on time (mean ± SD, 96%±6.6%). Mean ± SD cost was 0.56±0.59 SDs above the institutional average. Mean ± SD scores were 3.77±0.25 on 4-point and 4.06±0.31 to 4.94±0.08 on 5-point Likert-scaled surveys. Mean ± SD top box scores ranged from 18.6%±16.8% to 90.7%±10.5%. Learner survey scores were positively associated with patient survey scores ( r =0.26; P =.003) and negatively associated with years in practice ( r =-0.20; P =.02). Conclusion: This study provides validity evidence for 7 assessments commonly used by medical centers to measure physician performance and reports that top box scores amplify differences among high-performing physicians. These findings inform the most appropriate uses of physician performance data and provide practical guidance to organizations seeking to implement similar assessment programs or use existing performance data in more meaningful ways.
Databáze:	MEDLINE
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