- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04055103
Improving Quality Based on the Joint Registry (IQ Joint)
Study Overview
Status
Intervention / Treatment
Detailed Description
A randomized controlled trial will be conducted where hospitals will be randomized to an early versus late group, stratified by teaching status as this might influence the time available for quality improvement. Randomization will be done using a computer generated randomization table in a 1:1 ratio. During the study only orthopedic surgeons performing THA and TKA will receive monthly feedback by email.
The intervention will consist of the following components:
- Monthly feedback of performance outcomes;
- Education on how to use joint registry data for quality improvement;
- Create awareness by sending monthly feedback about performance; education and by asking what improvement activities have been introduced;
- Hospitals will be linked to hospital with opposite performance outcomes to exchange information and find areas for improvement.
During the trial, the investigators will conduct monthly measurement on intermediate outcomes showing whether the intervention reaches the target group (process evaluation). The following measurements will take place:
- Knowledge among orthopaedic surgeons on their recent performance and how that relates to others;
- Number of quality improvement activities undertaken with the aim to improve the quality of care;
- Planned improvement activities (e.g. record review to figure out why performance is not as good as in other centers) together with who is responsible and by which time;
- Number of people attending the meetings, number of times a specific account has accessed the LROI site to ensure that information has reached the target group;
- Survey among orthopaedic surgeons at the end of the intervention period on knowledge learned and the extent to which they think this is sustainable in daily practice.
In addition, the investigators will compare the outcomes between the early and the late group to test the effectiveness of the intervention, using the appropriate regression techniques. In the second period the investigators will test the sustainability of this approach in daily practice by comparing the outcomes within the early group with the first period, and compare with the late group to test whether outcomes in the sustainability phase are similar as when actively supported.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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Zuid-Holland
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Leiden, Zuid-Holland, Netherlands, 2333 ZA
- Leiden University Medical Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- ADULT
- OLDER_ADULT
- CHILD
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- All Dutch orthopedic clinics where hip- and knee replacement surgery is performed who agree to participate will be randomized.
Exclusion Criteria:
- None
Study Plan
How is the study designed?
Design Details
- Primary Purpose: SUPPORTIVE_CARE
- Allocation: RANDOMIZED
- Interventional Model: CROSSOVER
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Intervention Group
Half of the participating hospitals will be in the intervention group for the first 6 months.
The intervention will switch to the control group after the 6 months.
|
- Give monthly feedback from LROI-data (revision rate & patient reported outcome measures) as well as other outcomes from the participating hospital (length-of-stay, readmission and complications), combined with education on how to use this information for improvement.
This will be send monthly by email to the intervention group.
Further, hospitals with worse performance for a certain outcome will be linked to hospitals with good performance for this outcome.
|
NO_INTERVENTION: Control Group
Half of the participating hospitals will be in the control group for the first 6 months.
The control group will undergo the intervention in the second 6 months.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Survival (yes/no)
Time Frame: 1 year follow-up during trial
|
Patient survival after HA/TKA surgery
|
1 year follow-up during trial
|
1-year revision rate (%)
Time Frame: 1 year follow-up during trial
|
Number of revisions performed within one year adjusted for patient characteristics
|
1 year follow-up during trial
|
Prolonged length-of stay (yes/no)
Time Frame: 1 year follow-up during trial
|
Prolonged length-of-stay in the overall upper quartile
|
1 year follow-up during trial
|
Readmission (yes/no)
Time Frame: 1 year follow-up during trial
|
Readmission within 30 days after discharge
|
1 year follow-up during trial
|
Number of Complications
Time Frame: 1 year follow-up during trial
|
Number of complications
|
1 year follow-up during trial
|
Composite outcome measure (Textbook Outcome)
Time Frame: 1 year follow-up during trial
|
Including: Survival; 1-year revision rate; Length-of-Stay and Readmission.
|
1 year follow-up during trial
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Quality Improvement Initiatives
Time Frame: 1 year follow-up during trial
|
Number of quality improvement Initiatives with the aim to improve the quality of care
|
1 year follow-up during trial
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Perla Marang-van de Mheen, Dr., Leiden University Medical Center
Publications and helpful links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- G18.140
- VRF2018-001 (OTHER_GRANT: Van Rens Foundation)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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