• Adam Wolk, Erwin Wang, Bernard Horak, Patricia Cloonan, Michael Adams, Eileen Moore, Chitra Komal Jaipaul, Gabrielle Brown, Dabanjan Dasgupta, Danielle Deluca, and Mila Grossman.
• Department of Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia (Drs Wolk, Adams, Moore, and Jaipaul); Georgetown University School of Medicine, Washington, District of Columbia (Mr Wang); School of Nursing and Health Studies, Georgetown University, Washington, District of Columbia (Drs Horak and Cloonan and Ms Brown, Deluca, and Grossman); and University of Virginia, Charlottesville (Mr Dasgupta).
• Qual Manag Health Care. 2013 Oct 1; 22 (4): 272-5.

ObjectiveEvaluate the effect of a modest financial incentive on time-to-discharge summary dictation among medicine residents.BackgroundPay-for-performance incentives are used in a number of health care settings. Studies are lacking on their use with medical residents and other trainees. Timely completion of discharge summaries is necessary for effective follow-up after hospitalization, and residents perform the majority of discharge summary dictations in academic medical centers.MethodsMedicine residents with the lowest average discharge-to-dictation time during their 1-month inpatient medicine ward rotation were rewarded with a $50 gift card. Discharge data were captured using an autopopulating electronic database.ResultsThe average discharge-to-dictation time was reduced from 7.44 to 1.84 days, representing a 75.3% decrease. Almost 90% of discharge summary dictations were performed on the day of discharge.ConclusionA modest financial incentive resulted in a marked improvement in the time-to-discharge summary dictation by medicine residents. Pay-for-performance programs may be an effective strategy for improving the quality and efficiency of patient care in academic medical centers.

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