- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03966989
Improving Quality & Equity of Emergency Care Decisions (IQED) (IQED)
Improving Quality & Equity of Emergency Care Decisions (IQED): R21 Pilot Phase
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
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.
Each clinician will be randomized at the provider or clinic level to either the intervention or control group. Once clinicians are randomized, the aforementioned intervention will be turned on for a 3-6 month time period.
For providers in the intervention group, the goal is to evaluate the effect of social norms on overuse and underuse behavior related to prescriptions or testing. Near real-time social norms will be delivered to providers which benchmark their own performance on various metrics to that of their peers. The investigators performance feedback reports for each provider randomized to receive the audit and feedback intervention will have three key characteristics: (1) each target provider will receive his or her individual performance, (2) benchmarks will prominently feature the performance of providers who would be considered credible peers of the target provider, and (3) benchmarks will reflect only performance that is desirable (e.g., showing only the performance of the best-performing credible peers).
Providers randomized to the control group will follow standard practice.
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
California
-
Los Angeles, California, United States, 90033
- Lac + Usc
-
Sacramento, California, United States, 95817
- University of California, Davis
-
Sylmar, California, United States, 91342
- Olive View Medical Center
-
Torrance, California, United States, 90502
- Harbor UCLA
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Attendings and residents that see patients in the Emergency Department.
Exclusion Criteria:
- None
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Performance Feedback
Feedback offline either via email or text
|
Performance feedback offline that benchmarks providers' own performance to that of their peers
|
No Intervention: Control
Standard practice control
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Efficacy of behavioral nudges to improve quality and safety in Emergency Medicine through measurement of adherence to guidelines: Chest Pain
Time Frame: 6 months
|
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
Time Frame: 6 months
|
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
Time Frame: 6 months
|
Measurement of clinician adherence to guidelines for quality measures related to antibiotic prescribing (proportion of inappropriate antibiotic prescriptions for acute respiratory infections)
|
6 months
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Daniella Meeker, University of Southern California
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- HS-18-00522
- R21AG057400 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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