Improving Quality & Equity of Emergency Care Decisions (IQED) (IQED)
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|ClinicalTrials.gov Identifier: NCT03966989|
Recruitment Status : Suspended (Suspended due to COVID-19 pandemic)
First Posted : May 29, 2019
Last Update Posted : December 23, 2020
|Condition or disease||Intervention/treatment||Phase|
|Emergency Department||Behavioral: Performance Feedback||Not Applicable|
The objective of the R21 pilot phase of Improving Quality & Equity of Emergency Care Decisions (IQED) is to identify addressable gaps in quality and equity and use performance feedback as an intervention to improve performance on chest pain, CT imaging, and antibiotic prescribing. Performance feedback intervention will include feedback offline via email or text.
Each clinician will be randomized at the provider or clinic level to either the intervention or control group. Once clinicians are randomized, the aforementioned intervention will be turned on for a 3-6 month time period.
For providers in the intervention group, the goal is to evaluate the effect of social norms on overuse and underuse behavior related to prescriptions or testing. Near real-time social norms will be delivered to providers which benchmark their own performance on various metrics to that of their peers. The investigators performance feedback reports for each provider randomized to receive the audit and feedback intervention will have three key characteristics: (1) each target provider will receive his or her individual performance, (2) benchmarks will prominently feature the performance of providers who would be considered credible peers of the target provider, and (3) benchmarks will reflect only performance that is desirable (e.g., showing only the performance of the best-performing credible peers).
Providers randomized to the control group will follow standard practice.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||80 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Official Title:||Improving Quality & Equity of Emergency Care Decisions (IQED): R21 Pilot Phase|
|Estimated Study Start Date :||June 2021|
|Estimated Primary Completion Date :||June 2022|
|Estimated Study Completion Date :||June 2022|
Experimental: Performance Feedback
Feedback offline either via email or text
Behavioral: Performance Feedback
Performance feedback offline that benchmarks providers' own performance to that of their peers
No Intervention: Control
Standard practice control
- Efficacy of behavioral nudges to improve quality and safety in Emergency Medicine through measurement of adherence to guidelines: Chest Pain [ Time Frame: 6 months ]Measurement of clinician adherence to guidelines for quality measures related to chest pain (proportion of cases in which HEART score algorithm was used for chest pain patients)
- Efficacy of behavioral nudges to improve quality and safety in Emergency Medicine through measurement of adherence to guidelines: CT imaging [ Time Frame: 6 months ]Measurement of clinician adherence to guidelines for quality measures related to CT imaging (proportion of orders for unnecessary CT scans)
- Efficacy of behavioral nudges to improve quality and safety in Emergency Medicine through measurement of adherence to guidelines: Antibiotic prescribing [ Time Frame: 6 months ]Measurement of clinician adherence to guidelines for quality measures related to antibiotic prescribing (proportion of inappropriate antibiotic prescriptions for acute respiratory infections)
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03966989
|United States, California|
|Lac + Usc|
|Los Angeles, California, United States, 90033|
|University of California, Davis|
|Sacramento, California, United States, 95817|
|Olive View Medical Center|
|Sylmar, California, United States, 91342|
|Torrance, California, United States, 90502|
|Principal Investigator:||Daniella Meeker||University of Southern California|