The potentials of audit and feedback (AF) to improve healthcare are currently not exploited. To unlock the potentials of AF, this study focused on the process of making sense of audit data and translating data into actionable feedback by studying a specific AF-case: limiting antimicrobial resistance (AMR). This was done via audit and feedback of AMR prevention measures (APM) that are executed by healthcare workers (HCW) in their day-to-day contact with patients. This study’s aim was to counterbalance the current predominantly top-down, expert-driven audit and feedback approach for APM, with needs and expectations of HCW. Qualitative semi-structured interviews were held with sixteen HCW (i.e. physicians, residents and nurses) from high-risk AMR departments at a regional hospital in The Netherlands. Deductive coding was succeeded by open and axial coding to establish main codes, subcodes and variations within codes. HCW demand insights from audits into all facets of APM in their working routines (i.e. diagnostics, treatment and infection control), preferably in the form of simple and actionable feedback that invites interdisciplinary discussions, so that substantiated actions for improvement can be implemented. AF should not be seen as an isolated ad-hoc intervention, but as a recurrent, long-term, and organic improvement strategy that balances the primary aims of HCW (i.e. improving quality and safety of care for individual patients and HCW) and AMR-experts (i.e. reducing the burden of AMR). To unlock the learning and improvement potentials of audit and feedback, HCW’ and AMR-experts’ perspectives should be balanced throughout the whole AF-loop (incl. data collection, analysis, visualization, feedback and planning, implementing and monitoring actions). APM-AF should be flexible, so that both audit (incl. collecting and combining the right data in an efficient and transparent manner) and feedback (incl. persuasive and actionable feedback) can be tailored to the needs of various target groups. To balance HCW’ and AMR-experts’ perspectives a participatory holistic AF development approach is advocated.

中文翻译：

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找到医护人员和专家之间的匹配，以对抗菌素耐药性预防措施进行最佳审核和反馈。

目前尚未利用审计和反馈（AF）改善医疗保健的潜力。为了挖掘AF的潜力，本研究着重于通过研究特定的AF案例：限制抗菌素耐药性（AMR），使审计数据有意义并将数据转换为可行的反馈的过程。这是通过医护人员（HCW）在与患者的日常接触中执行的AMR预防措施（APM）的审核和反馈来完成的。这项研究的目的是与HCW的需求和期望相抵消，当前针对APM的主要是自上而下，专家驱动的审计和反馈方法。在荷兰的一家地区医院对来自高风险AMR部门的16名HCW（即医师，住院医师和护士）进行了定性半结构化访谈。演绎编码通过开放编码和轴向编码成功建立了主要代码，子代码和代码内的变体。HCW要求审计人员从APM的日常工作（即诊断，治疗和感染控制）的各个方面获得见识，最好采用简单且可操作的反馈形式，以引起跨学科讨论，以便可以采取切实可行的改进措施。心房颤动不应被视作孤立的临时干预，而应是一种经常性的，长期的，有机的改善策略，可以平衡HCW的主要目标（即提高对患者和HCW的护理质量和安全性）和AMR-专家（即减轻AMR的负担）。为了释放审计和反馈的学习和改进潜力，HCW和AMR专家的观点应该在整个AF循环中保持平衡（包括数据收集，分析，可视化，反馈和计划，实施和监视行动）。APM-AF应该具有灵活性，以便审计（包括以有效和透明的方式收集和合并正确的数据）和反馈（包括有说服力的和可行的反馈）都可以针对各种目标群体的需求进行调整。为了平衡HCW和AMR专家的观点，提倡一种参与性的整体性AF开发方法。有说服力和切实可行的反馈）可以针对各种目标群体的需求进行量身定制。为了平衡HCW和AMR专家的观点，提倡一种参与性的整体性AF开发方法。有说服力和切实可行的反馈）可以针对各种目标群体的需求进行量身定制。为了平衡HCW和AMR专家的观点，提倡一种参与性的整体性AF开发方法。