Daily Checklists and Outcome in the Intensive Care Unit

NCT ID: NCT01396044

Last Updated: 2012-12-04

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 451 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-07-31
• Study Completion Date: 2012-04-30

Brief Summary

Medical errors account for tens of thousands of deaths and tens of billions of dollars in healthcare costs in the United States every year. One field that has seen the strongest push toward quality improvement has been critical care medicine, likely because its particularly high degree of medical complexity makes it a practice area prone to high error rates with serious consequences. One of the most commonly used interventions used to help reduce errors in the intensive care unit (ICU) has been the implementation of checklists.

The investigators propose a clinical trial in a University critical care setting to determine whether an electronic checklist versus verbal prompting to use a written checklist improves clinical practice and patient outcomes. The investigators also plan to compare these data with a time period prior to the study to determine if the electronic checklist or verbal prompting are better than usual care. The investigators hypothesize that both the electronic checklist and verbal prompting to use a written checklist will be better for clinical practice and patient outcomes than usual care, and that verbal prompting will lead to better outcomes compared to the electronic checklist.

Conditions

Critical Illness

Keywords

Quality improvement; Checklist; Critical care; Anti-bacterial agents; Mechanical ventilation

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: SINGLE

Study Groups

Electronic checklist

Electronic checklist

Group Type: EXPERIMENTAL

Electronic checklist

Intervention Type: OTHER

Electronic checklist for process of care issues implemented in our institution. Training on a regular basis of the electronic checklist arm to use the electronic checklist. Process of care issues on the electronic checklist include several that are under investigation: antibiotics and mechanical ventilation.

Verbal prompting

Verbal prompting with written checklist

Group Type: EXPERIMENTAL

Verbal prompting

Intervention Type: OTHER

Prompting by study investigators of physicians on the verbal prompting arm. Prompting will include questions related to antibiotic utilization and mechanical ventilation weaning.

Interventions

Electronic checklist

Electronic checklist for process of care issues implemented in our institution. Training on a regular basis of the electronic checklist arm to use the electronic checklist. Process of care issues on the electronic checklist include several that are under investigation: antibiotics and mechanical ventilation.

Intervention Type: OTHER

Verbal prompting

Prompting by study investigators of physicians on the verbal prompting arm. Prompting will include questions related to antibiotic utilization and mechanical ventilation weaning.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Admission to a medical intensive care unit (MICU) team during the study timeframe

Exclusion Criteria

• Transfer from MICU team to a separate ICU team within 12 hours of admission
• Transfer to MICU team from a separate ICU team after more than 72 hours on the separate ICU team

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Parker B. Francis Fellowship Program

UNKNOWN

Sponsor Role: collaborator

Northwestern University

OTHER

Sponsor Role: lead

Responsible Party

Curtis Weiss

Instructor of Medicine

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Curtis H Weiss, MD

Role: PRINCIPAL_INVESTIGATOR

Northwestern University

Locations

Northwestern Memorial Hospital

Chicago, Illinois, United States

Northwestern University

Chicago, Illinois, United States

Countries

United States

References

Weiss CH, Moazed F, McEvoy CA, Singer BD, Szleifer I, Amaral LA, Kwasny M, Watts CM, Persell SD, Baker DW, Sznajder JI, Wunderink RG. Prompting physicians to address a daily checklist and process of care and clinical outcomes: a single-site study. Am J Respir Crit Care Med. 2011 Sep 15;184(6):680-6. doi: 10.1164/rccm.201101-0037OC. Epub 2011 May 26.

Reference Type: BACKGROUND

PMID: 21616996 (View on PubMed)

Other Identifiers

NUIRBSTU00013313

Identifier Type: -

Identifier Source: org_study_id