Nudging Healthcare Organizations to Adopt New Care Delivery Practices
Accelerating the Use of Evidence-based Innovation in Health Care Systems
研究概览
详细说明
The purpose of this study is to assess if behavioral 'nudges' impact the likelihood of healthcare organization administrators accessing technical assistance resources to support uptake of care delivery practices that: (1) have the potential to improve patient outcomes; and (2) have already been adopted by most healthcare organizations. A 'nudge' is a change in the way information is presented that attempts to steer people in a certain direction but does not restrict their choices.
The investigator will conduct a randomized controlled trial of written messages to healthcare administrators at three types of healthcare organizations - physician practices, hospitals and healthcare systems - from among 3,402 administrators who completed Dartmouth's National Survey of Healthcare Organizations and Systems (NSHOS) in 2017-2018.
In Fall 2019 the investigator will mail a customized report to all NSHOS respondents that compares their organizations' survey responses to their peer organizations. The investigator will randomize the 2,387 respondents whose organizations have not implemented one or more of up to seven chosen care delivery practices to cover letters with or without social norms messaging. The written messaging in the 'control condition' cover letter lists the practices for which the NSHOS team has prepared technical assistance materials in support of practice adoption, and contains a link to these online resources. The 'intervention condition' additionally highlights the organization's performance compared to its peers in adopting the practices using visual data display and explicit social norms messaging.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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New Hampshire
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Lebanon、New Hampshire、美国、03766
- Dartmouth Hitchcock Medical Center
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Participant responded to NSHOS survey and reported that their organization had not implemented at least one of up to seven pre-determined care delivery practices, out of the following eight practices featured in the NSHOS: Screening for opioid use specifically; Screening for substance use disorders; Screening for depression; Screening for interpersonal violence; Method for identifying high-cost patients; Use of evidence-based guidelines for congestive heart failure; Use of evidence-based guidelines for sepsis (included in letters to healthcare system administrators, but not hospitals or physician practices); Training for shared decision making (included in letters to hospitals and physician practices but not healthcare systems)
Exclusion Criteria:
- Did not respond to NSHOS survey
- Participant responded to NSHOS survey and reported that their organization had already implemented each of seven pre-determined care delivery practices, out of the following eight practices featured in the NSHOS: Screening for opioid use specifically; Screening for substance use disorders; Screening for depression; Screening for interpersonal violence; Method for identifying high-cost patients; Use of evidence-based guidelines for congestive heart failure; Use of evidence-based guidelines for sepsis (included in letters to healthcare system administrators, but not hospitals or physician practices); Training for shared decision making (included in letters to hospitals and physician practices but not healthcare systems)
学习计划
研究是如何设计的？
设计细节
- 主要用途：卫生服务研究
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的：Nudge Letter
Participants receive a letter that highlights their performance vs. peer organizations on up to seven care delivery practices featured in the National Survey of Healthcare Organizations and Systems (NSHOS).
The letter includes a link to access technical assistance resources and is sent alongside the participant's NSHOS respondent report.
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This group will receive a letter noting that their organization has not implemented at least one common care delivery practice that a majority their peers have already implemented.
The letter will also note the percentage of peer organizations that have implemented the practice.
This is done using peer comparison data and social norms messaging.
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无干预：Control Letter
Participants receive a letter with a link to technical assistance resources; the letter is sent alongside the participant's NSHOS survey respondent report.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Percentage of participants who access the technical assistance resource webpage
大体时间：Up to 2 months after letter is sent
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The percentage of participants who access the technical assistance webpage will be determined by email and webpage analytics.
The primary analysis will be intention to treat (i.e., among all participants sent a letter); a secondary analysis will be a 'per protocol' analysis (i.e., among all participants whose letter was not sent back as undeliverable).
Exploratory sub-group analyses will be conducted by each strata characteristic (e.g., whether organization category influences the likelihood of accessing the webpage).
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Up to 2 months after letter is sent
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Number of unique resource views on technical assistance resource webpage
大体时间：Up to 2 months after letter is sent
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The number of unique resources viewed from the webpage, as determined by website analytics.
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Up to 2 months after letter is sent
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Percentage of participants who request connection to peer organizations via the technical assistance resource webpage
大体时间：Up to 2 months after letter is sent
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The number of unique organizations that request to be matched with other healthcare organizations that have successfully implemented one of the care delivery practices, in order to learn from their experiences (there will be a clickable link on the webpage for organizations to request this connection).
This will be determined by website analytics.
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Up to 2 months after letter is sent
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Perceived effect of letter on administrators' intentions
大体时间：Up to 4 months after letter is sent
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Effect of letter on administrators' intentions and actions, measured by qualitative interviews in a sub-sample of participants.
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Up to 4 months after letter is sent
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合作者和调查者
调查人员
- 首席研究员：Amber E Barnato, MD, MPH, MS、Dartmouth College
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- Dartmouth IRB protocol #28763
- 1U19HS024075 (美国 AHRQ 拨款/合同)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
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