A mixed-methods study of facilitators and barriers of an audit and feedback intervention using key performance indicators for the Emergency Medical System in Northeastern Italy

Background. Audit and feedback (A&F) interventions are strategies used in different health care settings to monitor and improve professional practice and quality of assistance. However, when professional practice needs to be changed, barriers and enablers should be taken into account.
Material and methods. We conducted an online survey, a focus group, and a few interviews after disseminating two reports illustrating 61 key performance indicators (KPIs) describing the management of trauma, acute myocardial infarction and stroke in the Emergency Medical System of a Northeastern Italy Region. The study was conducted in the framework of the EASY-NET Project (NET-2016-02364191).
Results. Novelty, perception, communication, change, data, and pandemics are the primary themes describing the attitude of health care professionals towards an A&F intervention using KPIs.
Conclusions. Improving collaborations and providing specific education should be a primary concern before investing further resources in developing indicators and disseminating results.