Improving Quality & Equity of Emergency Care Decisions (IQED)

NCT03966989 | Withdrawn

• 2 other identifiers: HS-18-00522R21AG057400
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 4

Brief Summary

Recent work in emergency medicine has shown errors were more likely to occur at the end of shifts, as pressure exists to make a number of decisions simultaneously, and after what may be an already long series of cognitive challenges. Decision fatigue may also contribute to disparities by surfacing subconscious bias. The objective of the R21 pilot phase of Improving Quality \& Equity of Emergency Care Decisions (IQED) is to identify addressable gaps in quality and equity and use performance feedback as an intervention to improve performance on chest pain, CT imaging, and antibiotic prescribing. Performance feedback intervention will include feedback offline via email or text.

Conditions

Emergency Department

Keywords

Emergency Medicine; Behavioral Research

Outcome Measures

Primary Outcomes (3)

• Efficacy of behavioral nudges to improve quality and safety in Emergency Medicine through measurement of adherence to guidelines: Chest Pain

  Measurement of clinician adherence to guidelines for quality measures related to chest pain (proportion of cases in which HEART score algorithm was used for chest pain patients)

  6 months

• Efficacy of behavioral nudges to improve quality and safety in Emergency Medicine through measurement of adherence to guidelines: CT imaging

  Measurement of clinician adherence to guidelines for quality measures related to CT imaging (proportion of orders for unnecessary CT scans)

  6 months

• Efficacy of behavioral nudges to improve quality and safety in Emergency Medicine through measurement of adherence to guidelines: Antibiotic prescribing

  Measurement of clinician adherence to guidelines for quality measures related to antibiotic prescribing (proportion of inappropriate antibiotic prescriptions for acute respiratory infections)

  6 months

Study Arms (2)

Performance Feedback

EXPERIMENTAL

Feedback offline either via email or text

Behavioral: Performance Feedback

Control

NO INTERVENTION

Standard practice control

Interventions

Performance Feedback BEHAVIORAL

Performance feedback offline that benchmarks providers' own performance to that of their peers

Performance Feedback

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Attendings and residents that see patients in the Emergency Department.

You may not qualify if:

• None

Sponsors & Collaborators

• University of Southern California: lead
• National Institute on Aging (NIA): collaborator
• University of California, Los Angeles: collaborator
• Olive View-UCLA Education & Research Institute: collaborator
• LAC+USC Medical Center: collaborator
• University of California, Davis: collaborator

Study Sites (4)

Lac + Usc

Los Angeles, California, 90033, United States

Location

University of California, Davis

Sacramento, California, 95817, United States

Location

Olive View Medical Center

Sylmar, California, 91342, United States

Location

Harbor UCLA

Torrance, California, 90502, United States

Location

MeSH Terms

Conditions

Emergencies

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Daniella Meeker

  University of Southern California

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: May 14, 2019
• First Posted: May 29, 2019
• Study Start: December 1, 2021
• Primary Completion: June 1, 2022
• Study Completion: June 1, 2022
• Last Updated: December 20, 2021

Record last verified: 2021-12

Locations

US (4)