Improving Quality of Care for Elderly Patients in the Educational Setting

NCT01080235 | Completed DMC

• 1 other identifier: CPS 485
• Study Type: interventional
• Target: 42
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a multi-center exploratory study (each site got local IRB approval) of the impact of an educational toolkit combined with a practice-performance self-evaluation instrument (ABIM Care of the Vulnerable Elderly Practice Improvement Module) on trainee knowledge, skills, and attitudes about practice-based learning and improvement and systems-based practice in the care of elderly patients.

Conditions

Elderly

Keywords

quality improvement; geriatric care; residency training

Outcome Measures

Primary Outcomes (1)

• Practice Improvement Module (PIM) quality impact

  Assess the impact of the Care of the Vulnerable Elderly (CoVE) Practice Improvement Module to improve the quality of care received by elderly patients in the residency ambulatory setting.

  2 years

Secondary Outcomes (7)

• Assess satisfaction

  2 years

• Assess feasibility

  2 years

• Assess use of geriatric and quality improvement toolkit

  2 years

• Assess effects of disparities on elder care

  2 years

• Assess barriers in training setting

  2 years

Study Arms (2)

1

ACTIVE COMPARATOR

Control. Forty-two residency programs randomly assigned and stratified according to size, affiliation, geographic location, and presence of geriatrics fellowship. Twenty-one in the control arm. This group will use PIM as a data collection tool during baseline and follow-up time (i.e. audit of 50-75 charts, survey from 50-75 patients, and one system survey). They will not see the summary results of the data collected; they will not be required to complete a quality improvement plan based on the summary data. Local researchers will collect the data. Individual trainees will not do data collection or audits. At both baseline and follow-up, trainees will complete pre and post test surveys of 1) geriatric and 2) quality improvement knowledge, skills, and attitudes.

Other: Geriatric and Quality Improvement toolkit

2

OTHER

There are 21 residency programs in intervention arm who will 1) use PIM as a data collection tool (local researchers will audit 50-75 charts, survey 50-75 patients, and complete one system survey); 2) Each trainee will audit of up to five patient charts; collect 5 patient surveys; and complete the system survey as a group; 3) Summary data from these data streams will be reviewed by group; then they will design and implement a quality improvement plan; 4) At follow-up, local researchers will re-audit same 50-75 charts, collect surveys from same 50-75 patients, and complete one system survey. At baseline and follow-up, trainees and faculty will complete surveys of geriatric and quality improvement knowledge, skills, and attitudes.

Other: ABIM Care of Vulnerable Elderly Practice Improvement Module; Other: Geriatric and Quality Improvement toolkit

Interventions

ABIM Care of Vulnerable Elderly Practice Improvement Module OTHER

The ABIM CoVE PIM is a practice-performance self-evaluation instrument. It is a web-based tool based on nationally recognized guidelines that uses chart abstraction, patient surveys, and a practice system survey in order to generate a performance report focused on a key aspects of care for vulnerable elderly.

Also known as: Quality improvement module, Practice improvemnet module, Self-assesment in pratice based learning and improvement, PIM in residency

2

Geriatric and Quality Improvement toolkit OTHER

A resource toolkit about geriatrics and quality improvement was given to both study arms.

Also known as: The Improvement Guide by Langley and Nolan, Geriatrics at Your Fingertips, ACOVE Physician Education Program DVD, Online resources, Membership to AGS teaching slides website

1; 2

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• All residents at a resident clinic site
• Preceptors that are selected by the Champion for a particular resident clinic site
• Patients age 65 years or older for whom any of the following measures would be appropriate: falls prevention, identifying urinary incontinence, screening for depression and cognitive impairment, and providing other preventive care.
• Patients who have been in the practice for at least one year
• Patients who are ambulatory
• Patients who have been seen at least once by the practice within the past 12 months.

You may not qualify if:

• Patients under age 65
• Patients who have a terminal illness
• Patients with a life expectancy of less than one-year

Sponsors & Collaborators

• American Board of Internal Medicine: lead
• The Josiah Macy, Jr. Foundation: collaborator

Related Links

• ABIM website. Please go to "Helpful Resources" under "Residency Training" to see more information about the CoVE PIM.

MeSH Terms

Interventions

Aging

Intervention Hierarchy (Ancestors)

Growth and Development; Physiological Phenomena

Study Officials

• Eric S Holmboe, MD

  American Board of Internal Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Intervention Model: PARALLEL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: March 1, 2010
• First Posted: March 4, 2010
• Study Start: October 1, 2006
• Primary Completion: December 1, 2007
• Study Completion: December 1, 2008
• Last Updated: March 4, 2010

Record last verified: 2010-03