How Hospitals and Hospices Can Use Physician Feedback to Improve End-of-Life Patient Care

The goal of improving end-of-life care might find significant potential in a simple physician feedback approach.

A recent article in Hospitals & Health Networks* highlighted what happened when OhioHealth oncologists received data about their performance relative to their peers.

How they did it

The program involved polling oncologists to understand the “ideal” hospice length of stay, calculating the average length of stay across all oncologists in the network and then comparing that “ideal” and average to the actual length of stay for the individual oncologist.  Oncologists, surprised at the findings, changed their behavior, resulting in the average length of stay in hospice care for cancer patients nearly doubling within one year.

How can you do it

While this approach is groundbreaking in its results, it certainly is not as hard to implement as you might think.  Length of stay data by physician is readily available through Medicare and can be sorted and averaged easily.

Share the data amongst physicians if the MD’s are all part of the same group and are economically motivated to change practice patterns, such as those who are part of the Medicare Oncology Care Model, part of an ACO or a managed care incentive arrangement.  For example, here is a link to the 190+ practices who are part of the Medicare Oncology Care Model.  Participants receive a monthly payment to manage their care.  These physicians could be benchmarked against one another to understand their hospice referral patterns.

You can also utilize the Hospice Physician Behavior Report to provide general observations about physicians practicing in the same geographic area. The report identifies individual physicians and their specialty alongside of average length of stay.  Sort by specialty and calculate the average of numbers of days on hospice for all the oncologists.  Doctors can then be benchmarked against their peers to identify who has very short lengths of stay for their market.

The OhioHealth program identified that “feedback” seemed to be the key to changing behavior. The success was more about making physicians aware of where they stood in comparison to their peers, as well as what their own behavior patterns were.