Corresponding author: Patricia Jabre, (Samu de Paris, AP-HP, Necker-Enfants Malades Hospital, Paris, France) — patricia.jabre@aphp.fr
Submitted: 26 June 2026 · Accepted: 13 July 2026
Audit and feedback (A&F) is a commonly used method in healthcare. Previous studies, particularly in the field of behavioural theories, suggest that this method encourages healthcare professionals to modify their practice. However, current evidence in healthcare does not clearly establish whether this method is associated with improvements in practice or which types of A&F are the most effective.
What are the effects of A&F on healthcare professional practice, and which factors may explain variations in the effectiveness of A&F ?
A&F probably improves the quality of practice, prescribing, and the ordering of additional tests (moderate-certainty evidence). Evidence suggests that A&F is more effective when the audit focuses on an individual professional’s practice or on a single behaviour rather than on the whole team or a series of actions. Feedback has greater impact when delivered by a respected peer with an existing relationship with the professional and when there is substantial room for improvement. Comparing a professional’s performance with that of higher-performing peers and focusing on issues recognised as priorities by professionals may improve the effectiveness of A&F.
Several factors appear to increase the effectiveness of A&F: feedback delivered both verbally and in writing, the addition of an action plan alongside defined objectives, and feedback combined with other strategies such as training sessions, seminars, discussion groups, or regular reminders. In contrast, combining A&F with financial incentives or using it for punitive tone appears to be less effective or even counter-productive.
The authors reported substantial heterogeneity in the effects observed. In some studies, A&F was associated with a decline in performance and difficulties in maintaining improvements over time. This highlights that A&F is not a trivial managerial intervention. Future studies are needed to better understand when and how this intervention should be used.
1. Centre hospitalier de Selestat, Sélestat, France
2. Urgences CHU Tours, Tours, France
3. Samu de Paris, AP-HP, Necker-Enfants Malades Hospital, Paris, France
All authors contributed equally and validated the final version of record.
The Authors declare that there is no conflict of interest.
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
No registration applicable.
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Ethical approval for this study was not required.