Report Cards and Feedback for PCCE

NCT06155292 | Recruiting

• 1 other identifier: PCCE202324
• Study Type: interventional
• Target: 330
• Locations: 1 country
• Sites: 1

Brief Summary

As part of UCLA Health's commitment to developing an integrated health system built on a foundation of physician-led, team-based primary care, the Department of Medicine (DOM) implemented a performance-based incentive plan called the Primary Care Clinical Excellence (PCCE) Incentive Plan. The UCLA Health DOM Quality team is leading the implementation and evaluation of this incentive plan across the UCLA Health primary care network, with the primary goal to immediately produce improvements in the quality of primary care. In order to rigorously measure the most efficacious ways to frame and communicate information about the quality improvement (QI) program, the DOM Quality team has partnered with the UCLA Anderson School of Management. Understanding the factors that motivate physicians to deliver high quality primary care will provide pivotal insights into the successful implementation of performance based programs nationwide.

Conditions

Behavioral Economics; Primary Health Care; Health Maintenance

Keywords

behavioral economics; personalized feedback

Outcome Measures

Primary Outcomes (1)

• Physician Behavior: Rate of Engagement with Resources in First Email

  Whether physicians click through to access the "PCCE Resources and Improvement Strategies", for which a link is provided via quarterly report card emails. The time frame is one week after the first email was sent, as a binary indicator.

  1 week

Secondary Outcomes (5)

• Rate of Overall Resource Engagement

  12 months

• Domain-Specific and Aggregate PCCE Performance

  9 months

• Rate of Citizenship Behavior

  2 weeks

• Physician Workplace Attitudes

  12 months

• Physician Program-Related Attitudes and Perceptions

  12 months

Study Arms (3)

Arm 1: Standard Communication Arm

PLACEBO COMPARATOR

Quarterly email communication: Quarterly standard communication via email providing a link to physicians to check their PCCE program performance over the prior quarter, and a link to access the PCCE dashboard. The email will also include a link to resources. Starting with the email communication in February 2024, there will be a reminder email sent two weeks after the first email with the same content. Quarterly survey: Quarterly standard communication via survey with questions about physician attitudes and beliefs.

Behavioral: Standard Communication Email

Arm 2: Personalized Report Card

EXPERIMENTAL

Quarterly email communication: Quarterly personalized communication via email providing individualized performance metrics to physicians for the PCCE program from the prior quarter. All the links in the Arm 1 emails will be included in Arm 2 emails. Starting with the email communication in February 2024, there will be a reminder email sent two weeks after the first email with the same content. Quarterly survey: Quarterly standard communication via survey with the same questions about physician attitudes and beliefs as in Arm 1.

Behavioral: Personalized Report Card Email

Arm 3: Personalized Report Card + Bottom-Up Framing

EXPERIMENTAL

Quarterly email communication as in Arm 2. Bottom-up intervention: The quarterly email communication will also describe the ways in which the PCCE program and its features were informed by physician feedback and recommendations. Quarterly survey: The quarterly survey will include information about the ways in which the PCCE program and its features were informed by physician feedback and recommendations. Physicians will respond to the same questions about physician attitudes and beliefs as in Arms 1 and 2.

Behavioral: Personalized Report Card Email; Behavioral: Bottom-Up Framing

Interventions

Standard Communication Email BEHAVIORAL

This is a standard quarterly email communication without personalized performance metrics.

Arm 1: Standard Communication Arm

Personalized Report Card Email BEHAVIORAL

This personalized information about physician performance replaces the standard communication email to provide personalized feedback to physicians.

Arm 2: Personalized Report Card; Arm 3: Personalized Report Card + Bottom-Up Framing

Bottom-Up Framing BEHAVIORAL

The bottom-up framing is added onto the personalized communication email to provide insight on how the PCCE program was informed by physician feedback. The bottom-up framing is added onto the survey communication to provide insight on how the PCCE program was informed by physician feedback.

Arm 3: Personalized Report Card + Bottom-Up Framing

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Primary care physicians within the UCLA Health Department of Medicine Primary Care Network that are eligible for the PCCE Incentive program as of October 1, 2023.
• Physicians with the clinical full-time employee level (FTE) of ≥ 40% as of October 1, 2023
• Physicians with panel size \>50 patients as of October 1, 2023

You may not qualify if:

• Physicians classified as Pediatrics will be excluded from data analysis given the structural differences in health maintenance guidelines for children.
• Physicians classified as Urgent Care will be excluded from data analysis given the structural differences in their performance evaluation. They are all in Arm 1.
• Physicians who participate in the design of this experiment will be excluded from analysis.

Sponsors & Collaborators

• University of California, Los Angeles: lead

Study Sites (1)

UCLA Health Department of Medicine, Quality Office

Los Angeles, California, 90095, United States

RECRUITING

Related Publications (7)

• Colquitt JA. On the dimensionality of organizational justice: a construct validation of a measure. J Appl Psychol. 2001 Jun;86(3):386-400. doi: 10.1037/0021-9010.86.3.386.

  PMID: 11419799 BACKGROUND

• Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211.

  BACKGROUND

• Konovsky, M. A. (2000). Understanding procedural justice and its impact on business organizations. Journal of Management, 26(3), 489-511. https://doi.org/10.1016/S0149-2063(00)00042-8

  BACKGROUND

• Leventhal, H. (1980). Toward a comprehensive theory of emotion. In Advances in experimental social psychology (Vol. 13, pp. 139-207). Elsevier.

  BACKGROUND

• Shapiro, D. L., Buttner, E. H., & Barry, B. (1994). Explanations: What factors enhance their perceived adequacy? Organizational Behavior and Human Decision Processes, 58(3), 346-368.

  BACKGROUND

• Thibault, J., & Walker, L. (1975). Procedural justice: A social psychological analysis. Hillsdale, NJ: Lawrence Elbaum Associates.

  BACKGROUND

• Bies, R. J., & Moag, J. S. 1986. Interactional justice; Communication criteria of fairness. In R. J. Lewicki, B. H. Sheppard, & B. H. Bazerman (Eds.), Research on negotiation in organizations, Vol. 1: 43-55. Greenwich, CT: JAI Press.

  BACKGROUND

Study Officials

• Richard Leuchter, MD

  UCLA Health

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ilana Brody

CONTACT

7032445470; ilana.brody.phd@anderson.ucla.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Instructor

Model Details: Parallel randomized trial at the physician level.

Study Record Dates

• First Submitted: October 3, 2023
• First Posted: December 4, 2023
• Study Start: October 3, 2023
• Primary Completion: October 31, 2024
• Study Completion: October 31, 2025
• Last Updated: January 30, 2025

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)