Effectiveness of Report Cards Based on Chart Audits of Residents' Adherence to Practice Guidelines on Practice Performance: A Randomized Controlled Trial

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Abstract
Medical record audits have been used to provide physicians with feedback about their compliance with preventive health and disease management recommendations. To determine if report cards summarizing medicine residents' preventive health and disease management practices can be used as a feedback tool to improve practice performance. Randomized, blinded, controlled study of 44 internal medicine residents using an individualized 78-item report card based on outpatient record audits. Four hundred ninety-seven charts were retrospectively audited at baseline and 284 charts in follow-up. There were no significant differences in baseline performance between the residents in the intervention and control group. There were no differences in performance scores between residents receiving report cards and those who had not in immunizations, counseling, total preventive health, diabetes, hypertension, and total disease management. Intensive data-based feedback using report cards may not be a successful way to improve ambulatory performance of medical house officers.