Re-Purposing the Ordering of Routine Laboratory Tests in Hospitals in British Columbia
NCT ID: NCT06359587
Last Updated: 2024-12-19
Study Results
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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RECRUITING
NA
700000 participants
INTERVENTIONAL
2024-05-06
2026-10-01
Brief Summary
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Detailed Description
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The intervention bundle will contain tools to promote education around appropriate use of laboratory testing in hospitals (using an online module, clinical decision support tool), will share data on laboratory test utilization patterns locally, and include patient engagement materials (infographic and video).
Local champions in hospitals will form multidisciplinary implementation teams to facilitate adaptation and delivery of implementation tools within local context. A pragmatic stepped-wedge design will be used to implement the intervention bundle in 16 hospitals grouped into 8 clusters. Historical data from March 2018 will be collected to understand trends, including the impact of electronic medical record (EMR) implementation and coronavirus disease (COVID-19) on laboratory test utilization.
The first 4 weeks of implementation will be a pre-intervention period, trialing and adapting tools to the local context. Readiness assessments and workflow observations will be conducted to understand organizational readiness for implementation. Clusters will enter the intervention period during the latter 8 weeks of the implementation period where intervention tools will be deployed.
Data will be collected for at least 24 weeks post-implementation, evaluating the impact of tools without dedicated personnel support. Access to educational resources will continue, and laboratory utilization reports will be sent.
Conditions
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Study Design
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RANDOMIZED
SEQUENTIAL
This arm involves the time periods where hospital units are actively receiving the intervention bundle, including healthcare provider (HCP) and patient engagement tools.
Control Arm (No Intervention Bundle Implementation):
This arm represents the time periods when the hospital units do not receive the intervention bundle. This time period is the control period. Each hospital will contribute to intervention and control period data.
HEALTH_SERVICES_RESEARCH
NONE
Study Groups
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Intervention Arm (Intervention Bundle Implementation)
This arm involves the time periods of the hospital units where the LTO bundle, including healthcare provider and patient engagement tools, is actively implemented.
Laboratory test overuse (LTO) Bundle
Key Components of the LTO Bundle:
Educational materials, including an online module, clinical decision support tool, provision of lab utilization (Audit and Feedback) reports for healthcare providers.
Patient engagement tools, such as videos and educational infographics. System level implementation tools adapted to the local context, including EMR-based tools and order set changes, etc.
Control Arm (No LTO Bundle Implementation)
This arm represents the time period of hospital units where the LTO bundle is not implemented.
No interventions assigned to this group
Interventions
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Laboratory test overuse (LTO) Bundle
Key Components of the LTO Bundle:
Educational materials, including an online module, clinical decision support tool, provision of lab utilization (Audit and Feedback) reports for healthcare providers.
Patient engagement tools, such as videos and educational infographics. System level implementation tools adapted to the local context, including EMR-based tools and order set changes, etc.
Eligibility Criteria
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Inclusion Criteria
* Attending Physicians: All physicians who provide patient care in the general internal medicine or family medicine (hospitalist) provider groups in selected hospitals
* Learners and allied health staff (Medical Students/Resident physicians/Clinical Assistants/ Nurse Practitioners, etc.): All those who help take care of patients and can order labs during the study period in the under general internal medicine or family medicine (hospitalist) provider groups in selected hospitals The date range for both groups will extend from May 2024 until study completion in October 2026.
Exclusion Criteria
* Patients and Health Care Providers (HCPs) who are not in the internal medicine or family medicine groups
18 Years
ALL
No
Sponsors
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Providence Health & Services
OTHER
Vancouver Coastal Health
OTHER_GOV
Fraser Health
OTHER
Interior Health
INDUSTRY
Northern Hospital, Australia
OTHER
Canadian Institutes of Health Research (CIHR)
OTHER_GOV
Island Health
OTHER
University of British Columbia
OTHER
Responsible Party
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Anshula Ambasta
Assistant Professor
Principal Investigators
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Anshula Ambasta
Role: PRINCIPAL_INVESTIGATOR
University of British Columbia
Locations
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University Hospital of Northern British Columbia
Prince George, British Columbia, Canada
Mount St. Joseph's Hospital
Vancouver, British Columbia, Canada
Vancouver General Hospital
Vancouver, British Columbia, Canada
St. Paul's Hospital
Vancouver, British Columbia, Canada
Countries
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Central Contacts
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Facility Contacts
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Anurag Singh
Role: primary
Alyssa Shariff
Role: primary
Penny Tam
Role: primary
Anshula Ambasta
Role: primary
References
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Ambasta A, Holroyd-Leduc JM, Pokharel S, Mathura P, Shih AW, Stelfox HT, Ma I, Harrison M, Manns B, Faris P, Williamson T, Shukalek C, Santana M, Omodon O, McCaughey D, Kassam N, Naugler C. Re-Purposing the Ordering of Routine Laboratory Tests in Hospitalized Medical Patients (RePORT): protocol for a multicenter stepped-wedge cluster randomised trial to evaluate the impact of a multicomponent intervention bundle to reduce laboratory test over-utilization. Implement Sci. 2024 Jul 2;19(1):45. doi: 10.1186/s13012-024-01376-6.
Other Identifiers
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H22-03005
Identifier Type: -
Identifier Source: org_study_id