Systematic Quality Improvement With Realtime Event Support

Telemedicine Clinical Trial

— SQUIRES  

Official title:

Systematic Quality Improvement With Realtime Event Support

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04983329
• Other study ID #: 202107031
• Status: Completed
• Phase: N/A
• Start date: November 8, 2021
• Est. completion date: September 10, 2022

Study information

• Verified date: April 2023
• Source: Washington University School of Medicine
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of this study is to improve perioperative quality metric performance in patients receiving anesthesia care provided by Washington University Department of Anesthesiology. In this protocol, we describe (1) the use of telemedicine-augmented quality improvement interventions to enhance on-time dosage of surgical prophylactic antibiotics, while (2) carrying out large scale monitoring of surgical site infection incidence in the target population. If this quality improvement framework is found to be feasible and successful, we plan subsequently to study its application to additional perioperative quality metrics, including many pertinent to surgical site infection incidence such as perioperative glucose monitoring and management, and intraoperative temperature management.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 25506
• Est. completion date: September 10, 2022
• Est. primary completion date: June 12, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Patients having procedures at Barnes-Jewish Hospital in suites not part of the TECTONICS trial will be included.

Exclusion Criteria:

• Patients enrolled in the ongoing TECTONICS intraoperative Anesthesiology Control Tower telemedicine trial at Barnes-Jewish Hospital will be excluded from this study

Related Conditions & MeSH terms

• Telemedicine

Intervention

Other:
• Telemedicine intervention
Following education, the telemedicine center will subsequently monitor operating rooms included in this trial for protocol adherence for three-months. The telemedicine center is staffed by attending anesthesiologists, resident anesthesiologists, certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) and is currently providing evidence-based support to clinicians in a subset of operating rooms and post-anesthesia care unit (PACU) beds at Barnes-Jewish Hospital.

Locations

Country	Name	City	State
United States	Washington University School of Medicine/Barnes Jewish Hospital	Saint Louis	Missouri

Sponsors (1)

Lead Sponsor	Collaborator
Washington University School of Medicine

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Improvement in administration of surgical antibiotic prophylaxis- intervention period	1a. Increase the rate of on-time surgical antibiotic prophylaxis administration prior to incision during the intervention period.	3 months
Primary	Improvement in administration of surgical antibiotic prophylaxis-after quality improvement intervention	1b. Increase the rate of on-time surgical antibiotic prophylaxis administration prior to incision six weeks after the quality improvement intervention is completed.	2 months
Primary	Improvement in administration of surgical antibiotic prophylaxis	1c. Increase the rate of on-time re-dosing of antibiotic prophylaxis throughout the duration of the trial.	8 months
Secondary	Surgical site infection rate	Decrease the proportion of patients which develop surgical site infections throughout the duration of the trial.	8 months