Can 360-Degree Reviews Help Surgeons? Evaluation of Multisource Feedback for Surgeons in a Multi-Institutional Quality Improvement Project.
BACKGROUND
Medical organizations have increased interest in identifying and improving behaviors that threaten team performance and patient safety. Three hundred and sixty degree evaluations of surgeons were performed at 8 academically affiliated hospitals with a common Code of Excellence. We evaluate participant perceptions and make recommendations for future use.


METHODS
Three hundred and eighty-five surgeons in a variety of specialties underwent 360-degree evaluations, with a median of 29 reviewers each (interquartile range 23 to 36). Beginning 6 months after evaluation, surgeons, department heads, and reviewers completed follow-up surveys evaluating accuracy of feedback, willingness to participate in repeat evaluations, and behavior change.


RESULTS
Survey response rate was 31% for surgeons (118 of 385), 59% for department heads (10 of 17), and 36% for reviewers (1,042 of 2,928). Eighty-seven percent of surgeons (95% CI, 75%-94%) agreed that reviewers provided accurate feedback. Similarly, 80% of department heads believed the feedback accurately reflected performance of surgeons within their department. Sixty percent of surgeon respondents (95% CI, 49%-75%) reported making changes to their practice based on feedback received. Seventy percent of reviewers (95% CI, 69%-74%) believed the evaluation process was valuable, with 82% (95% CI, 79%-84%) willing to participate in future 360-degree reviews. Thirty-two percent of reviewers (95% CI, 29%-35%) reported perceiving behavior change in surgeons.


CONCLUSIONS
Three hundred and sixty degree evaluations can provide a practical, systematic, and subjectively accurate assessment of surgeon performance without undue reviewer burden. The process was found to result in beneficial behavior change, according to surgeons and their coworkers.
Ariadne Labs, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard School of Public Health, Boston, MA.
Suliat M
SM
Nurudeen
Ariadne Labs, Boston, MA; Brigham and Women's Hospital, Boston, MA.
Gifty
G
Kwakye
Ariadne Labs, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard School of Public Health, Boston, MA.
William R
WR
Berry
Beth Israel Deaconess Medical Center, Boston, MA.
Elliot L
EL
Chaikof
Massachusetts General Hospital, Boston, MA.
Keith D
KD
Lillemoe
South Shore Hospital, South Weymouth, MA.
Frederick
F
Millham
North Shore Medical Center, Salem, MA.
Marc
M
Rubin
Cambridge Health Alliance, Cambridge, MA.
Steven
S
Schwaitzberg
Boston Children's Hospital, Boston, MA.
Robert C
RC
Shamberger
Brigham and Women's Hospital, Boston, MA.
Michael J
MJ
Zinner
Risk Management Foundation of the Harvard Medical Institutions, Inc, Cambridge, MA.
Luke
L
Sato
Ariadne Labs, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard School of Public Health, Boston, MA.
Stuart
S
Lipsitz
Ariadne Labs, Boston, MA; Brigham and Women's Hospital, Boston, MA; Harvard School of Public Health, Boston, MA.
Atul A
AA
Gawande
Ariadne Labs, Boston, MA; Harvard School of Public Health, Boston, MA; Massachusetts General Hospital, Boston, MA. Electronic address: abhaynes@mgh.harvard.edu.
Alex B
AB
Haynes
D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D058996:Quality Improvement; D066231:Surgeons / Q000592:standards*