Improved health care quality and safety require changes in physicians and systems of care. Such change is difficult and slow. We propose to develop a patient-centered feedback system that would provide """"""""glancible"""""""" data to test sites selected from our 40 site practice-based research network, HamesNet. This streaming feedback system, called a """"""""practice dashboard"""""""" would gather data from patients using exit questions administered via a touch screen kiosk and linked, with a small delay to assure patient confidentiality, to a flat screen monitor display in the clinic. Previous research has indicated that feedback loops and report card type data can be effective in practice change. The patient-centeredness, glancible reporting method, and immediacy of reports of this proposal build on reported previous successes. ? ? The primary research question is whether a """"""""practice dashboard"""""""" can stimulate practice change as measured by patient report? Sted at two beta practice sites where feasibility and acceptability data will be gathered from patients and physicians. These data will assess optimal reporting frequency, presentation formatting, and practical considerations such as kiosk placement and patient literacy issues. Subsequently a controlled trial will occur over a 6-week measurement period in two intervention and two control sites, each with multiple practitioners. ? ? This pilot proposal will provide the foundation necessary to develop a larger scale """"""""practice dashboard"""""""" intervention. Potential applications, identified in early discussions with our network Physicians', include diagnostic/disease management questions, more specific safety questions, patient satisfaction, patient centeredness, and behaviorally-based health problems. ? ? ? ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????
