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NCT Number: NCT02593253

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

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.

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Key information

Conditions

Quality Improvement

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of California San Francisco

San Francisco, California, 94143, United States

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

  • None

Treatment and study plan

Audit and Feedback Bundle

Other

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

Other

The control arm will undergo audit and feedback per the current system, which is biweekly feedback emails with performance on selected quality measures.

Primary outcomes

  1. Proportion of patients with a high quality after visit summary

    Time frame: 6 months

    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.

  2. Proportion of patients with discharge summary timeliness

    Time frame: 6 months

    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

  3. Proportion of patients Complete Medication Reconciliation by Discharge

    Time frame: 6 months

    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.

  4. Proportion of patients achieving a high quality 'perfect' discharge

    Time frame: 6 months

    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.

Secondary outcomes

  1. Proportion of attending and resident physicians who 'strongly agree' that they are satisfied with the audit and feedback of performance data that they receive.

    Time frame: 6 months

    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.

  2. Total Phlebotomy Sticks

    Time frame: 6 months

    The total number of unique accession numbers for each unique hospitalization of a patient

  3. Percent of Patients on Telemetry Until Discharge

    Time frame: 6 months

    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

  4. Proportion of patients discharged by noon

    Time frame: 6 months

    The number of patients discharged by hospital medicine team attendings by noon (6am-11:59am)/total number of discharges by hospital medicine team attendings

Sponsors and collaborators

Lead sponsor

University of California, San Francisco

Other

Registry information

Official study title

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

Important dates

Study start
2016
Primary completion
2016
Study completion
2017
First posted
Nov 2, 2015
Registry last updated
May 9, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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