The Effect of a Novel Audit and Feedback Bundle on Inpatient Performance

Quality Improvement Clinical Trial

Official title:

The Effect of a Novel Electronic Physician Audit and Feedback Bundle on Inpatient Performance Metrics

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02593253
• Other study ID #: 15-17709
• Status: Completed
• Phase: N/A
• First received: October 23, 2015
• Last updated: May 5, 2017
• Start date: February 2016
• Est. completion date: May 2017

Study information

• Verified date: May 2017
• Source: University of California, San Francisco
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This single-blinded, cluster randomized control trial will assess the effectiveness of an audit and feedback bundle on internal medicine physician performance on selected quality metrics. The feedback bundle includes an electronic dashboard and weekly feedback rounds in which physicians will review their performance. The control arm will undergo audit and feedback per the current system, which is biweekly feedback emails with performance.

Description:

This is a single-blinded, cluster randomized control trial of 48 internal medicine teams (24 teams will be randomized to the intervention arm and and 24 teams randomized to control arm) on inpatient medicine wards. Each team consists of at least 4 members (attending physician, senior resident, two interns). The intervention arm teams will receive the new audit and feedback bundle, which includes access to the electronic dashboard and weekly feedback rounds in which they review their performance on several inpatient quality metrics via the electronic dashboard. The control arm will undergo audit and feedback per the current system, which is biweekly feedback emails with performance on selected quality measures. This primary aim of the trial will be to compare the effectiveness of performance feedback on inpatient quality metrics specifically high quality after visit summary, medical reconciliation and discharge summary timeliness. Other group comparisons will include other inpatient quality metrics and satisfaction with feedback.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 200
• Est. completion date: May 2017
• Est. primary completion date: December 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All physicians that rotate through internal medicine wards during the study period (teaching attending physicians and internal medicine residents and interns)

Exclusion Criteria:

Related Conditions & MeSH terms

• Quality Improvement

Intervention

Other:
• Audit and Feedback Bundle
The intervention arm teams will receive the new audit and feedback bundle, which includes access to the electronic dashboard and weekly feedback rounds in which they review their performance on several inpatient quality metrics via the dashboard.
• Bi-weekly audit and feedback emails
The control arm will undergo audit and feedback per the current system, which is biweekly feedback emails with performance on selected quality measures.

Locations

Country	Name	City	State
United States	University of California San Francisco	San Francisco	California

Sponsors (1)

Lead Sponsor	Collaborator
University of California, San Francisco

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Proportion of patients with a high quality after visit summary	The number of hospital medicine team patients with after visit summaries of high quality divided by the total number hospital medicine team patients with an after visit summary.	6 months
Primary	Proportion of patients with discharge summary timeliness	The number of discharge summaries completed within 24 hours of discharge for hospital medicine team patients/total number of discharges from hospital medicine with a discharge summary completed	6 months
Primary	Proportion of patients Complete Medication Reconciliation by Discharge	The total number of patients with an action taken on all home medications divided by the total number of patients on the hospital medicine teaching service.	6 months
Primary	Proportion of patients achieving a high quality 'perfect' discharge	Proportion of patients who have a high quality after visit summary and a discharge summary completed within 24 of discharge and all medications reconciled by discharge.	6 months
Secondary	Proportion of attending and resident physicians who 'strongly agree' that they are satisfied with the audit and feedback of performance data that they receive.	Proportion of attending and resident physicians who 'strongly agree' that they are satisfied with the audit and feedback of performance data that they receive. This specific satisfaction item has been developed by the study team.	6 months
Secondary	Total Phlebotomy Sticks	The total number of unique accession numbers for each unique hospitalization of a patient	6 months
Secondary	Percent of Patients on Telemetry Until Discharge	The number of patients on without a discontinue order for telemetry within two hours of their discharge date time divided by the total number of patients on telemetry for hospital medicine teams	6 months
Secondary	Proportion of patients discharged by noon	The number of patients discharged by hospital medicine team attendings by noon (6am-11:59am)/total number of discharges by hospital medicine team attendings	6 months