Evaluation of the Effectiveness of an Audit and Feedback Intervention With Quality Improvement Toolbox in Intensive Care

Pain Management Clinical Trial

Official title:

Increasing the Effectiveness and Understanding of Audit and Feedback Interventions in Intensive Care: Protocol for a Mixed-methods Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02922101
• Other study ID #: METC_W16_271
• Status: Completed
• Phase: N/A
• Start date: September 2016
• Est. completion date: October 2018

Study information

• Verified date: January 2019
• Source: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study evaluates the addition of a quality improvement toolbox to an online audit and feedback intervention in Dutch intensive care units. The toolbox comprises for each quality indicator (e.g., percentage of patients per shift whose pain is measured) a list of potential bottlenecks in the care process (e.g., staff is unaware of the prevailing guidelines for measuring pain every shift), associated recommendations for actions to solve mentioned bottlenecks (e.g., organize an educational training session), and supporting materials to facilitate implementation of the actions (e.g., a slide show presentation discussing the importance and relevance of measuring pain every shift). Half of the participating intensive care units will only receive online feedback, while the other half will additionally gain access to the integrated toolbox to facilitate planning and executing actions.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 21
• Est. completion date: October 2018
• Est. primary completion date: October 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• ICUs treating adult (18 years and above) patients

• ICUs willing and able to submit data monthly

• ICUs with a local quality improvement team of at least 1 intensivist and 1 nurse

Exclusion Criteria:

Related Conditions & MeSH terms

• Critical Care
• Pain Management
• Quality Improvement

Intervention

Behavioral:
• Audit and Feedback
An online dashboard that provides insight into clinical performance on pain management quality indicators. It also incorporates an empty action plan, in which participating intensive care units can define potential bottlenecks in the care process and what actions they intend to undertake to improve.
• Toolbox
A quality improvement toolbox, incorporated within the action plan, that comprises for each pain management quality indicator (e.g., percentage of patients per shift whose pain is measured) a list of potential bottlenecks in the care process (e.g., staff is unaware of the prevailing guidelines for measuring pain every shift), associated recommendations for actions to solve mentioned bottlenecks (e.g., organize an educational training session), and supporting materials to facilitate implementation of the actions (e.g., a slide show presentation discussing the importance and relevance of measuring pain every shift).

Locations

Country	Name	City	State
Netherlands	National Intensive Care Evaluation foundation	Amsterdam	Noord-Holland

Sponsors (2)

Lead Sponsor	Collaborator
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)	National Intensive Care Evaluation Foundation

Country where clinical trial is conducted

Netherlands, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change from proportion of patient shifts during which pain has been adequately managed	"Adequately managed" is defined: pain measured AND (acceptable pain score OR (unacceptable pain score AND normalized within 1 hour)). The primary outcome measure is a composite score of four quality indicators (= secondary outcome measures).The measure is limited to only patients' first 12 shifts to prevent bias from patients with a long stay. There are 3 shifts in 1 day.	9 months
Secondary	Change from proportion of patient shifts during which pain was measured at least once		9 months
Secondary	Change from proportion of patient shifts during which pain was measured and no unacceptable pain scores were observed		9 months
Secondary	Change from proportion of patient shifts during which an unacceptable pain score was measured, and pain was timely re-measured		9 months
Secondary	Change from proportion of patient shifts during which an unacceptable pain score was measured, and pain was timely re-measured indicating that the pain score was normalized		9 months