A Brief Intervention to Improve Cost-effective Resource Use Among Medicine Housestaff

June 21, 2011 updated by: Brigham and Women's Hospital

OBJECTIVE: To test a brief intervention designed to improve the cost-effectiveness of care provided by medicine housestaff for hospitalized patients.

HYPOTHESIS: A brief intervention in which medicine residents receive itemized bills for recent patients cared for by them, followed by a discussion on approaches to reducing unnecessary inpatient costs, can result in significant cost reductions without adversely affecting patient outcomes.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

We designed a brief educational intervention with two primary objectives: 1) to increase awareness among residents about how their decisions impact the costs of inpatient medical care; and 2) to improve the cost-effectiveness of care provided by residents without adversely affecting patient outcomes. We hypothesized that a brief intervention in which residents receive bills for patients they recently cared for, followed by a discussion on approaches to reducing unnecessary inpatient costs, would reduce costs without adversely affecting patient outcomes.

Study Type

Interventional

Enrollment (Actual)

96

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Massachusetts
      • Boston, Massachusetts, United States, 02115
        • Brigham & Women's Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Internal Medicine Residents on Inpatient Rotations at Brigham & Women's Hospital

Exclusion Criteria:

  • Having a team member who was in either the control group or intervention group in a prior round of this study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Allocation: Randomized

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Intervention Group
Residents Randomized to Receive Educational Intervention
Behavioral: Educational Intervention
45-minute teaching session on healthcare costs, in which each resident reviewed an itemized hospital bill for a patient he/she had cared for, followed by an open-ended discussion about reducing unnecessary costs.
No Intervention: Control Group
Residents randomized not to receive a teaching intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total Cost
Time Frame: 2 weeks following educational intervention
Total hospital cost per admission for 2 weeks following the educational intervention.
2 weeks following educational intervention
Lab Cost
Time Frame: 2 weeks following educational intervention
Total lab cost per admission for 2 weeks following the educational intervention.
2 weeks following educational intervention
Pharmacy Cost
Time Frame: 2 weeks following educational intervention
Total pharmacy cost per admission for 2 weeks following the educational intervention.
2 weeks following educational intervention
Radiology Cost
Time Frame: 2 weeks following educational intervention
Total radiology cost per admission for 2 weeks following the educational intervention.
2 weeks following educational intervention

Secondary Outcome Measures

Outcome Measure
Time Frame
length of stay
Time Frame: 2 weeks after educational intervention
2 weeks after educational intervention
admission to an intensive care unit (ICU)
Time Frame: 2 weeks after educational intervention
2 weeks after educational intervention
30-day readmission
Time Frame: within 30 days after end of study period
within 30 days after end of study period
30-day mortality
Time Frame: within 30 days after end of study period
within 30 days after end of study period

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Brigham and Women's Hospital

Collaborators

Partners Center of Expertise in Quality and Patient Safety

Investigators

  • Principal Investigator: David Bates, MD, Brigham and Women's Hospital
  • Study Director: Benjamin D Sommers, MD, PhD, Brigham and Women's Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2009

Primary Completion (Actual)

December 1, 2010

Study Completion (Actual)

February 1, 2011

Study Registration Dates

First Submitted

February 23, 2011

First Submitted That Met QC Criteria

February 23, 2011

First Posted (Estimate)

February 24, 2011

Study Record Updates

Last Update Posted (Estimate)

June 22, 2011

Last Update Submitted That Met QC Criteria

June 21, 2011

Last Verified

February 1, 2011

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2009-P-001758/1; BWH

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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