Systematic Quality Improvement With Realtime Event Support

NCT04983329 | Completed

• 1 other identifier: 202107031
• Study Type: interventional
• Target: 25,506
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study is to improve perioperative quality metric performance in patients receiving anesthesia care provided by Washington University Department of Anesthesiology. In this protocol, we describe (1) the use of telemedicine-augmented quality improvement interventions to enhance on-time dosage of surgical prophylactic antibiotics, while (2) carrying out large scale monitoring of surgical site infection incidence in the target population. If this quality improvement framework is found to be feasible and successful, we plan subsequently to study its application to additional perioperative quality metrics, including many pertinent to surgical site infection incidence such as perioperative glucose monitoring and management, and intraoperative temperature management.

Conditions

Telemedicine

Keywords

Telemedicine; Quality-Improvement; surgical antibiotics

Outcome Measures

Primary Outcomes (3)

• Improvement in administration of surgical antibiotic prophylaxis- intervention period

  1a. Increase the rate of on-time surgical antibiotic prophylaxis administration prior to incision during the intervention period.

  3 months

• Improvement in administration of surgical antibiotic prophylaxis-after quality improvement intervention

  1b. Increase the rate of on-time surgical antibiotic prophylaxis administration prior to incision six weeks after the quality improvement intervention is completed.

  2 months

• Improvement in administration of surgical antibiotic prophylaxis

  1c. Increase the rate of on-time re-dosing of antibiotic prophylaxis throughout the duration of the trial.

  8 months

Secondary Outcomes (1)

• Surgical site infection rate

  8 months

Study Arms (1)

Improvement in administration of surgical antibiotic prophylaxis.

OTHER

The eight-month module will include a baseline phase, educational interventions, real-time guidance from a remote telemedicine center, regular feedback regarding adherence to protocols related to that module, and continued silent monitoring.

Other: Telemedicine intervention

Interventions

Telemedicine intervention OTHER

Following education, the telemedicine center will subsequently monitor operating rooms included in this trial for protocol adherence for three-months. The telemedicine center is staffed by attending anesthesiologists, resident anesthesiologists, certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) and is currently providing evidence-based support to clinicians in a subset of operating rooms and post-anesthesia care unit (PACU) beds at Barnes-Jewish Hospital.

Improvement in administration of surgical antibiotic prophylaxis.

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients having procedures at Barnes-Jewish Hospital in suites not part of the TECTONICS trial will be included.

You may not qualify if:

• Patients enrolled in the ongoing TECTONICS intraoperative Anesthesiology Control Tower telemedicine trial at Barnes-Jewish Hospital will be excluded from this study

Sponsors & Collaborators

• Washington University School of Medicine: lead

Study Sites (1)

Washington University School of Medicine/Barnes Jewish Hospital

St Louis, Missouri, 63110, United States

Location

Study Officials

• Troy Wildes, MD

  Washington Univeristy School of Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assoc Prof of Anesthesiology

Study Record Dates

• First Submitted: July 16, 2021
• First Posted: July 30, 2021
• Study Start: November 8, 2021
• Primary Completion: June 12, 2022
• Study Completion: September 10, 2022
• Last Updated: April 28, 2023

Record last verified: 2023-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)