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Quality Improvement/Patient Safety: Improvement Science Research Methods

QI 1: Improvement Science Research Methods & Evaluation of QI Educational Interventions

680 - Offering Maintenance of Certification Improves Research Survey Adherence

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 680
Publication Number: 680.151

Lindsay A. Thompson, Wake Forest Baptist Health - Brenner Children's Hospital, Winston Salem, NC, United States; Carma Bylund, University of Florida, Gainesville, FL, United States; Marta D. Hansen, University of Florida College of Medicine, Gainesville, FL, United States; Gabriela Sanchez, University of Florida, Lake Worth, FL, United States; Stephanie A S. Staras, University of Florida College of Medicine, Gainesville, FL, United States

Presenting Author(s)

Lindsay A. Thompson, MD (she/her/hers)

Chair, Department of Pediatrics
Wake Forest Baptist Health - Brenner Children's Hospital
Winston Salem, North Carolina, United States

Background: Many pediatricians find fulfilling two Maintenance of Certification (MOC) QI projects in each five-year board certification cycle hard. Research, QI and implementation projects also struggle with participation, especially when investigating clinician behavior. Research can build in MOC to potentially incentivize study engagement.

Objective:

To test if offering an MOC part 4 activity yielded higher completion rates of interval research surveys.

Design/Methods: This study was conducted as a sub-analysis from a large, prospective trial, Text & Talk (R37CA234030) which randomizes HPV vaccine recommendation strategies by clinic for clinicians who see 11-12-year-old patients (physicians (MDs/DOs) and extenders (PAs, APRNs)). There are 2 intervention arms and 1 delayed arm. Clinicians in the intervention arms participated in one-hour trainings on the C-LEAR approach to HPV vaccine recommendations for parents of 11- to 12-year-olds, and thus had more interaction than the delayed arm clinicians who will not receive the training until after the study. All clinicians receive small ($5) cash incentives for completing brief study surveys on three of their 11-12-year-old patients each month for a year for a total of 36 possible surveys. Physicians who opt into an MOC activity complete three additional brief questions each survey. Physician extenders are ineligible for MOC part 4 credit. To assess the usefulness of MOC credit as an additional incentive, we compared the response rates (calculated as a positive response if >50% of all brief surveys were completed) by MOC participation, MOC eligibility and study arms.

Results: Overall, all study arms had a similarly high percentage of female and white, non-Hispanic clinicians; (Table 1). Many chose MOC participation (71.1% in the intervention arms and 47.4% in the delayed arm). Regardless of study arm assignment, physicians who chose to participate in MOC had between 36-54% higher survey response rates than physicians who chose not to participate in MOC (Figure 1). Among all intervention arms, response rates were 73.2% among MOC physicians and 37.9% among non-MOC participating physicians (p value < .001). Physician extenders (who are ineligible for MOC) had the highest response rates (p value < .001).

Conclusion(s):

In addition to small cash incentives, physicians who also chose MOC credit responded at rates up to 54% higher. Since gains in participation rates are difficult, MOC credits should be used as a viable tool to increase survey completion rates among physicians. Future studies may consider other incentives to engage physicians unmotivated by MOC credit.