Improving Quality & Equity of Emergency Care Decisions (IQED)

NCT ID: NCT03966989

Last Updated: 2021-12-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2021-12-31

Study Completion Date

2022-06-30

Brief Summary

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Recent work in emergency medicine has shown errors were more likely to occur at the end of shifts, as pressure exists to make a number of decisions simultaneously, and after what may be an already long series of cognitive challenges. Decision fatigue may also contribute to disparities by surfacing subconscious bias. 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.

Detailed Description

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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.

Conditions

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Emergency Department

Keywords

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Emergency Medicine Behavioral Research

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Performance Feedback

Feedback offline either via email or text

Group Type EXPERIMENTAL

Performance Feedback

Intervention Type BEHAVIORAL

Performance feedback offline that benchmarks providers' own performance to that of their peers

Control

Standard practice control

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Performance Feedback

Performance feedback offline that benchmarks providers' own performance to that of their peers

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Attendings and residents that see patients in the Emergency Department.

Exclusion Criteria

* None
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

University of California, Los Angeles

OTHER

Sponsor Role collaborator

Olive View-UCLA Education & Research Institute

OTHER

Sponsor Role collaborator

LAC+USC Medical Center

OTHER

Sponsor Role collaborator

University of California, Davis

OTHER

Sponsor Role collaborator

University of Southern California

OTHER

Sponsor Role lead

Responsible Party

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Daniella Meeker

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Daniella Meeker

Role: PRINCIPAL_INVESTIGATOR

University of Southern California

Locations

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Lac + Usc

Los Angeles, California, United States

Site Status

University of California, Davis

Sacramento, California, United States

Site Status

Olive View Medical Center

Sylmar, California, United States

Site Status

Harbor UCLA

Torrance, California, United States

Site Status

Countries

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United States

Other Identifiers

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R21AG057400

Identifier Type: NIH

Identifier Source: secondary_id

View Link

HS-18-00522

Identifier Type: -

Identifier Source: org_study_id