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You can lead clinicians to water, but you can’t make them drink: the role of tailoring in clinical performance feedback to improve care quality
  1. Laura Desveaux1,2,
  2. Zahava R S Rosenberg-Yunger1,3,
  3. Noah Ivers4,5
  1. 1 Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
  2. 2 Institute for Health Policy, Management, and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
  3. 3 Toronto Metropolitan University, Toronto, Ontario, Canada
  4. 4 Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
  5. 5 Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Laura Desveaux, Institute for Better Health, Trillium Health Partners, Mississauga, ON L5B 1B8, Canada; laura.desveaux{at}

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Health systems worldwide are focused on improving patient and population healthcare outcomes. Data are increasingly leveraged to support these aims, including clinical performance feedback (CPF) initiatives that provide clinicians with data on how often their patients are receiving evidence-based care compared with a specific improvement goal, which may reflect a standardised target or how they perform in comparison to their peers.1 2 Unfortunately, engagement with and impact of providing data is variable. We need to tailor data to the nature of its clinician recipients in the same way we tailor the nature of care to the individual patient. This will require continued investment in producing and analysing data and a better understanding of the clinicians whose behaviours we are trying to optimise. CPF initiatives that truly help clinicians achieve their goals in this regard are more likely to be well received. Imagine a future in which CPF is tailored for clinicians in the same way that Amazon, Google and Netflix personalise interfaces, informed by a range of data points and usability heuristics.

CPF initiatives focus their efforts on telling clinicians what the outcome should be instead of better understanding them as recipeients and the resources or skills they need to improve those outcomes. It should not be surprising then that upwards of one-third of clinicians who sign up to receive voluntary CPF do not engage with it.3 In order to effectively tailor CPF we need to couple ongoing investments in producing and analysing routinely collected data with insights about the people whose attention we are trying to capture and whose clinical behaviours we are trying to optimise. Such insights would form the foundation for tailoring our strategies that seek to improve quality of care.

The continued implementation of CPF initiatives with a one-size-fits-all mentality is a design flaw …

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  • Twitter @lauradesveaux, @ZRS_Rosenberg

  • Contributors LD, ZRSR-Y and NI all participated in the conceptualisation and writing of the manuscript. All authors read and approved the final manuscript.

  • Funding This study was funded by the Canadian Institutes of Health Research and the Canada Research Chairs.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.