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Audit and Feedback (A&F) is a widely utilized and promising solution to reduce unwarranted physician-level variation in care, yet its impact is variable in practice and uptake is often suboptimal. While recipient characteristics are acknowledged as an important driver of interaction with A&F reports, surprisingly little attention has been paid to understanding these characteristics and their mechanisms of action. From a control-value perspective, we developed and tested an integrated theoretical model delineating the modifiable antecedents to engaging with A&F by measuring recipient attitudes, beliefs, and regulatory focus in the healthcare context. By using a partial least squares path modeling technique, we found that 1) recipients' commitment to act on feedback is influenced by both their perceived value of and perceived confidence in acting on feedback; 2) both pathways of influence are mediated by perceived usefulness of feedback; 3) recipients' perceived need for change influences their perceived value of acting on feedback; and 4) prevention focus has a negative but insignificant association with perceived usefulness of feedback. Our findings contribute to a more in-depth understanding of the upstream cognitive appraisal process of A&F, which determines recipients' intention to interact with A&F. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic thrust health systems worldwide into levels of unprecedented strain. As the pandemic waves recede, a new challenge emerges—addressing the healthcare needs of a growing population against the backdrop of historical backlogs, worsening access, and health system burnout. This reality has prompted many hospitals to revisit their strategic plans with an emphasis on modernizing healthcare delivery. Some hospitals have opted for a population health approach, which encompasses the delivery of acute care along with proactively promoting the overall health of the population. The successful execution of this approach requires aligning health system leaders' comprehension of this approach and its operationalization. In this qualitative case study, we interviewed 13 senior leaders at a large community hospital to explore their perspectives and beliefs regarding the operationalization of a population health approach. We found varying accounts of the approach's value, benefits, and importance, highlighting an opportunity to align leaders' thinking. Leaders identified the organization's low risk tolerance and decision-making structures as cultural aspects requiring evolution to support success. These findings illustrate the current state from which the organization aims to evolve and underscore the importance of identifying and aligning leaders' underlying perspectives and beliefs as a precursor to successful implementation. [ABSTRACT FROM AUTHOR]