Impact of provider feedback on quality improvement in rehabilitation services: an interrupted time series analysis.

The study was underpowered: it recruited 2,415 patients against a planned 4,000, and the number of measurement points was uneven, with 11 before the intervention and 9 after. Patients answered the quality questions three months after admission, not at discharge, so they may have misremembered details of their stay. The intervention was a single 3.5-hour session with no follow-up, and the researchers did not check how institutions actually used the reports or whether they made changes. The post-intervention period overlapped with the start of the COVID-19 pandemic, which may have affected care delivery. Patients were excluded if they had severe cognitive impairment or psychiatric conditions that would stop them completing digital questionnaires, so the results may not apply to those groups. The feedback was given to all centres on the same day, so it is impossible to separate the effect of the feedback from other changes happening in the system at that time.

The work was funded by FoU Virke Rehabilitation and REMEDY, a centre for rheumatic and musculoskeletal diseases. The authors state the funders had no role in the design, analysis, interpretation or writing.

Do not conclude that a small rise in process scores means the feedback worked. That change lost statistical significance once the models accounted for centre and time, and the overall result was null.