InPART RX - Epicenters

NCT07368660 | Completed DMC

• 3 other identifiers: 2025P009466U54CK000601-01STUDY00003936
• Study Type: interventional
• Target: 169
• Locations: 1 country
• Sites: 4

Brief Summary

InPART Rx is a collaborative research study to measure the impact of a planned quality improvement initiative to reduce unnecessary antibiotic prescribing by the Hospital Medicine Service through a process of receiving peer-comparison summary prescribing data bimonthly. The initiative is a collaboration between EHC Pharmacy, the School of Medicine (SOM) Division of Infectious Diseases, and the SOM Hospital Medicine Service. Roughly one-third of antibiotics prescribed in the hospital setting are for the wrong dose, wrong drug, or wrong duration, resulting in considerable unnecessary antibiotic exposure among the inpatient population. Such use increases patient risk for adverse events such as infectious diarrhea or antibiotic-resistant infections. Inpatients cared for by Hospital Medicine providers are a growing proportion of all patients, and developing efficient techniques to reduce unnecessary antibiotic prescribing by these providers would benefit this growing population of patients. The research team aims to measure the impact of implementing a process to provide peer comparisons of antibiotic prescribing among Hospitalists at four Emory Healthcare (EHC) hospitals back to these providers in an effort to minimize unnecessary antibiotic prescribing. All 147 current Hospital Medicine Service providers will participate as part of the Division's quality improvement effort, receiving no compensation. Only summary patient encounter information without private health insurance (PHI) will be presented back to the providers; investigators will track changes in summary prescribing metrics and summary patient outcomes every month. If such an automated peer-comparison feedback process is effective in safely reducing unnecessary antibiotic prescriptions in EHC, similar processes may be adapted to other inpatient provider groups or serve as a model for other healthcare systems. The goal of this quality improvement (QI) work is to use traditional QI methods of peer-comparison through data feedback to improve antibiotic prescribing among EHC HMS by reducing unnecessary antibiotic use and improving patient safety on the EHC HMS.

Conditions

Hospital Infection; Standardized Antibiotic Prescribing Ratio (SAR)

Keywords

Stepped wedge; Stewardship; Hospitalists; Quality Metrics; Antibiotics Prescription; C. Difficile Infection (CDI)

Outcome Measures

Primary Outcomes (1)

• Observed provider-specific antibiotic prescribing rate

  The observed provider-specific antibiotic prescribing rate is defined as the billed days of therapy (DOT) of Broad-Spectrum, Hospital-Onset (BS-HO) antibiotics per 1000 billed patient-days.

  Baseline and bimonthly for 2 years

Secondary Outcomes (4)

• C. difficile infection

  Up to 8 weeks post discharge (9 weeks from admission on average)

• Number of participants with a prolonged length of initial hospital stay

  Hospital stay, an average of 10 days

• In-hospital mortality

  Hospital admission, an average of 7 days

• Hospital readmissions

  30 days after hospital discharge

Study Arms (2)

HMS Providers

EXPERIMENTAL

Hospitalists will receive messages via email every 2 months with comparison data of the previous 2 months and antibiotic prescribing educational content. HMS providers will be receiving data on prescribing as part of the intervention.

Other: Messaging Hospitalists

Usual Care Arm (Control)

OTHER

Hospitalists will receive bimonthly educational emails about simple steps to improve antibiotic prescribing.

Other: Usual Care

Interventions

Messaging Hospitalists OTHER

The intervention has two parts: (1) a one-time educational session on antibiotic de-escalation, and (2) bimonthly email feedback reports. Educational sessions, led by facility stewardship leads, focused on evidence-based recommendations for presumed pneumonia and urosepsis, specifically indications for empiric anti-pseudomonal coverage and use of Emory Healthcare's antibiotic prescribing assistance tool. Feedback reports reinforced these indications and provided a link to the tool.

HMS Providers

Usual Care OTHER

The usual care arm will be an educational email about simple steps to improve antibiotic prescribing sent bimonthly to all hospitalists.

Usual Care Arm (Control)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• All Hospital Medicine Service (HMS) Providers at either Emory University Hospital (EUH), Emory University Hospital Midtown (EUHM), Emory Johns Creek Hospital (EJCH), or Emory St. Joseph's Hospital (ESJH)

You may not qualify if:

• None

Sponsors & Collaborators

• Emory University: lead
• Centers for Disease Control and Prevention: collaborator

Study Sites (4)

Emory Saint Joseph's Hospital

Atlanta, Georgia, 30308, United States

Location

Emory University Hospital Midtown (EUHM)

Atlanta, Georgia, 30308, United States

Location

Emory University Hospital (EUH)

Atlanta, Georgia, 30322, United States

Location

Emory Johns Creek Hospital

Johns Creek, Georgia, 30097, United States

Location

MeSH Terms

Conditions

Cross Infection

Condition Hierarchy (Ancestors)

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

Study Officials

• Scott K. Fridkin, MD

  Emory University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Medicine and Epidemiology

Model Details: Stepped wedge cluster randomized approach of a quality improvement effort of peer comparative inpatient prescribing reports sent to hospitalists in 5 hospitals. The intervention will be rolled out sequentially to all 5 hospitals in 3-month intervals. The intervention will last 18 months at all 5 sites.

Study Record Dates

• First Submitted: January 20, 2026
• First Posted: January 26, 2026
• Study Start: January 1, 2023
• Primary Completion: December 31, 2024
• Study Completion: December 31, 2024
• Last Updated: January 26, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (4)