NCT02593253

Brief Summary

This single-blinded, cluster randomized control trial will assess the effectiveness of an audit and feedback bundle on internal medicine physician performance on selected quality metrics. The feedback bundle includes an electronic dashboard and weekly feedback rounds in which physicians will review their performance. The control arm will undergo audit and feedback per the current system, which is biweekly feedback emails with performance.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
200

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Feb 2016

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 23, 2015

Completed
10 days until next milestone

First Posted

Study publicly available on registry

November 2, 2015

Completed
3 months until next milestone

Study Start

First participant enrolled

February 1, 2016

Completed
10 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2016

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2017

Completed
Last Updated

May 9, 2017

Status Verified

May 1, 2017

Enrollment Period

10 months

First QC Date

October 23, 2015

Last Update Submit

May 5, 2017

Conditions

Quality Improvement

Keywords

Quality ImprovementQuality Indicators, Health CareHospital Medicine

Outcome Measures

Primary Outcomes (4)

  • Proportion of patients with a high quality after visit summary

    The number of hospital medicine team patients with after visit summaries of high quality divided by the total number hospital medicine team patients with an after visit summary.

    6 months

  • Proportion of patients with discharge summary timeliness

    The number of discharge summaries completed within 24 hours of discharge for hospital medicine team patients/total number of discharges from hospital medicine with a discharge summary completed

    6 months

  • Proportion of patients Complete Medication Reconciliation by Discharge

    The total number of patients with an action taken on all home medications divided by the total number of patients on the hospital medicine teaching service.

    6 months

  • Proportion of patients achieving a high quality 'perfect' discharge

    Proportion of patients who have a high quality after visit summary and a discharge summary completed within 24 of discharge and all medications reconciled by discharge.

    6 months

Secondary Outcomes (4)

  • Proportion of attending and resident physicians who 'strongly agree' that they are satisfied with the audit and feedback of performance data that they receive.

    6 months

  • Total Phlebotomy Sticks

    6 months

  • Percent of Patients on Telemetry Until Discharge

    6 months

  • Proportion of patients discharged by noon

    6 months

Study Arms (2)

Intervention Audit and Feedback Bundle

EXPERIMENTAL

Access to the electronic dashboard and weekly feedback rounds

Other: Audit and Feedback Bundle

Bi-weekly audit and feedback emails

ACTIVE COMPARATOR

Access to biweekly feedback emails with performance on selected quality measures (current practice).

Other: Bi-weekly audit and feedback emails

Interventions

Audit and Feedback BundleOTHER

The intervention arm teams will receive the new audit and feedback bundle, which includes access to the electronic dashboard and weekly feedback rounds in which they review their performance on several inpatient quality metrics via the dashboard.

Intervention Audit and Feedback Bundle
Bi-weekly audit and feedback emailsOTHER

The control arm will undergo audit and feedback per the current system, which is biweekly feedback emails with performance on selected quality measures.

Bi-weekly audit and feedback emails

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • All physicians that rotate through internal medicine wards during the study period (teaching attending physicians and internal medicine residents and interns)

You may not qualify if:

  • None

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of California San Francisco

San Francisco, California, 94143, United States

Location

Related Publications (1)

  • Patel S, Rajkomar A, Harrison JD, Prasad PA, Valencia V, Ranji SR, Mourad M. Next-generation audit and feedback for inpatient quality improvement using electronic health record data: a cluster randomised controlled trial. BMJ Qual Saf. 2018 Sep;27(9):691-699. doi: 10.1136/bmjqs-2017-007393. Epub 2018 Mar 5.

    PMID: 29507124DERIVED

Study Officials

  • Alvin R Rajkomar, MD

    University of California, San Francisco

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
INVESTIGATOR
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 23, 2015

First Posted

November 2, 2015

Study Start

February 1, 2016

Primary Completion

December 1, 2016

Study Completion

May 1, 2017

Last Updated

May 9, 2017

Record last verified: 2017-05

Locations

US(1)