Clinical performance feedback is an important component of ongoing development and education of health care practitioners. For physicians, feedback about their clinical practice and outcomes is central to developing both confidence and competence at all stages of their medical careers. Appreciating that provider self-reflection plays an important role in quality-of-care and cost, Niagara Health, a five-hospital, multi-site organization serving 450,000 residents across Niagara Region, sought to provide opportunities for learning and growth to the Emergency physician group across all sites through the introduction of the Emergency Physician Reflective Review tool.

Despite the inherent challenges in accessing data through disparate technological systems, and pre-existing fears around a judgmental culture, the NH ED is providing non-punitive quality and efficiency metrics on an individualized basis. For the past 8 years, the tool has been in place at the St. Catharines hospital, and in 2017, the practice spread to all sites. This tool helps encourage physicians to a) self-reflect on their clinical practice, b) seek feedback among colleagues and share best practices, and c) build a culture of learning, improvement, and patient safety.

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