View clinical trials related to Quality Improvement.
Filter by:With more frequent extreme weather events, climbing atmospheric Carbon dioxide and unabated use of fossil fuels, planetary health and sustainability will become crucial to future medical practice. Clinical educators must rise to the challenge, educating and empowering tutees to ensure their understanding of green healthcare principles and solutions. Research at the University College London and the Universities of Bristol and Exeter has been conducted into engaging medical students with the theory of sustainability. What has not been explored is how to have them engage with the topic practically, providing them with frameworks and opportunities to their knowledge into practical scenarios. What we propose is a short study conducted over the period of a month in October 2023 that pairs educational sessions to answer the research question: do practical workshops help to cement sustainable teaching for attendees, help them bring out their individual ideas and experience surrounding sustainability, and empower them to implement comparable solutions in their clinical practice? Historically, these projects have ignored multidisciplinary practice. Specialists of any grade in any field can practice sustainability. As such, any healthcare student/professional is eligible, pending their consent. To facilitate this broad eligibility base, and to bring diversity of ideas to the workshops, both students at Liverpool University and any interested staff at the Liverpool University Hospitals Foundation Trust will be eligible for the project. Following a pre-session questionnaire to gauge baseline, participants will be taught the core principles of clinical sustainability in a remote 2-hour, interactive lecture-based session. This would be followed up by a hybrid 2-hour practical workshop session later that week. Here, those consenting to attend will have a chance to work through different clinical scenarios with experts in different fields. Each session will have feedback forms to gauge compounding of knowledge, engagement and empowerment, our primary outcome measures.
A prospective, multicenter and cluster randomised controlled trial will be conducted, using hospital as randomisation unit. Hospitals in Zhejiang Province, China, will be randomised into two arms (1:1): an intervention arm and a control arm. Hospitals in the intervention arm will receive a multilevel system intervention based on information platform, whereas hospitals in the control arm will receive no intervention. The randomisation will be conducted after baseline data collection. The following baseline data will be used for randomisation match: hospital classification, beds in stroke centre, and the number of acute ischemic stroke (AIS) patients within 7 days of stroke onset. Hospitals with <250 AIS cases per year will be excluded from the study. The primary outcome will be difference between intervention arm and control arm in the one-year stroke recurrence rate on the follow-up stage (post-intervention).
Optimal prescribing of antimicrobials is becoming increasingly challenging because of the growing complexity of guidelines and constantly changing distribution of infectious pathogens. Prescribing antimicrobials appropriately according to local guidelines optimizes therapy for the individual patient and reduces the emergence of resistance. By adapting and evaluating a smartphone based app containing local guidelines we aim to study appropriate prescribing of antimicrobials by physicians in three hospitals (Netherlands, Sweden and Switzerland).