Features and effectiveness of electronic audit and feedback for patient safety and quality of care in hospitals: A systematic review.

Abstract

Background: Increasing digitisation in healthcare is flowing through to quality improvement strategies, like audit and feedback. Objectives: To systematically review electronic audit and feedback (e-A&F) interventions in hospital settings, examining contemporary practices and quantitatively assessing the relationship between features and effectiveness. Methods: We performed a systematic review using a structured search strategy from 2011 to July 2022. Searches yielded a total of 5095 unique publications, with 152 included in a descriptive synthesis, reporting publication characteristics and practices, and 63 in the quantitative synthesis, to evaluate the effect size of intervention features. Results: The search returned publications across characteristics, including countries of origin, feedback topics, target health professionals, and study design types. We also identified an association with effectiveness for all but one of the features examined, with a Cohen's d ranging from above +0.8 (a large positive effect), to -0.67 (a medium negative effect). Socio-technical features related to supportive organisations and the involvement of engaged health professionals were most associated with effective interventions. Conclusion: Key findings have confirmed that a common set of features of e-A&F systems can influence effectiveness. Results provide practitioners with insight into where resources should be focused during the implementation of e-A&F.