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This study found that national audit impacts may be enhanced by strengthening all aspects of feedback cycles, particularly effective feedback, and considering how different ways of reinforcing feedback act together.

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Thomas A Willis 1, Alexandra Wright-Hughes 2, Ana Weller 3, Sarah L Alderson 1, Stephanie Wilson 3, Rebecca Walwyn 2, Su Wood 1, Fabiana Lorencatto 4, Amanda Farrin 2, Suzanne Hartley 2, Jillian Francis 5, Valentine Seymour 5, Jamie Brehaut 6, Heather Colquhoun 7, Jeremy Grimshaw 6, Noah Ivers 8, Richard Feltbower 9, Justin Keen 1, Benjamin C Brown 10,11, Justin Presseau 6,12, Chris P Gale 9,13,14, Simon J Stanworth 15,16,17,18, Robbie Foy 1,*

1 Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
2 Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
3 Centre for Human-Computer Interaction Design, City, University of London, London, UK
4 Centre for Behaviour Change, University College London, London, UK
5 School of Health Sciences, City, University of London, London, UK
6 Ottawa Hospital Research Institute, Ottawa, ON, Canada
7 Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
8 Women’s College Hospital, Toronto, ON, Canada
9 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
10 Centre for Health Informatics, University of Manchester, Manchester, UK
11 Centre for Primary Care, University of Manchester, Manchester, UK
12 School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
13 Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
14 Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
15 Transfusion Medicine, NHS Blood and Transplant (NHSBT), Oxford, UK
16 Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
17 Radcliffe Department of Medicine, University of Oxford, Oxford, UK
18 NIHR Oxford Biomedical Research Centre, Oxford, UK
* Corresponding author Email:

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