跳至主要内容
临床试验/NCT07368660
NCT07368660已完成不适用

InPART Rx - Inpatient Provider Antibiotic Rate Benchmarking to Reduce Unnecessary Prescribing

Emory University4 个研究点 分布在 1 个国家目标入组 169 人开始时间: 2023年1月1日最近更新:
干预措施

试验速览

阶段
不适用
状态
已完成
入组人数
169
试验地点
4
主要终点
Observed provider-specific antibiotic prescribing rate

研究概览

简要总结

InPART Rx is a collaborative research study to measure the impact of a planned quality improvement initiative to reduce unnecessary antibiotic prescribing by the Hospital Medicine Service through a process of receiving peer-comparison summary prescribing data bimonthly. The initiative is a collaboration between EHC Pharmacy, the School of Medicine (SOM) Division of Infectious Diseases, and the SOM Hospital Medicine Service.

Roughly one-third of antibiotics prescribed in the hospital setting are for the wrong dose, wrong drug, or wrong duration, resulting in considerable unnecessary antibiotic exposure among the inpatient population. Such use increases patient risk for adverse events such as infectious diarrhea or antibiotic-resistant infections. Inpatients cared for by Hospital Medicine providers are a growing proportion of all patients, and developing efficient techniques to reduce unnecessary antibiotic prescribing by these providers would benefit this growing population of patients.

The research team aims to measure the impact of implementing a process to provide peer comparisons of antibiotic prescribing among Hospitalists at four Emory Healthcare (EHC) hospitals back to these providers in an effort to minimize unnecessary antibiotic prescribing. All 147 current Hospital Medicine Service providers will participate as part of the Division's quality improvement effort, receiving no compensation. Only summary patient encounter information without private health insurance (PHI) will be presented back to the providers; investigators will track changes in summary prescribing metrics and summary patient outcomes every month. If such an automated peer-comparison feedback process is effective in safely reducing unnecessary antibiotic prescriptions in EHC, similar processes may be adapted to other inpatient provider groups or serve as a model for other healthcare systems.

The goal of this quality improvement (QI) work is to use traditional QI methods of peer-comparison through data feedback to improve antibiotic prescribing among EHC HMS by reducing unnecessary antibiotic use and improving patient safety on the EHC HMS.

详细描述

The intervention is messaging to hospitalists via email every 2 months (bi-monthly) that contains peer comparison data of the previous 2 months and antibiotic prescribing educational content.

The details of the content may include a relative rank in prescribing metrics, with blinding to specific peers' identities, and department-wide and facility-specific goals highlighted. Those in the lowest prescribing quartile will earn the designation of "Top Performer". The usual care arm will be an educational email about simple steps to improve antibiotic prescribing sent bimonthly to all hospitalists.

Data Sources: The primary source of data will be the Emory Hospital (EH) Clinical Data Warehouse (CDW), a repository that integrates data from multiple clinical applications within EHC and has the flexibility to create customized, research-specific metrics for all adults (≥18 years old) admitted to the HMS at either Emory University Hospital (EUH), Emory University Hospital Midtown (EUHM), Emory Johns Creek Hospital (EJCH), or Emory St. Joseph's Hospital (ESJH).

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Health Services Research
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • All Hospital Medicine Service (HMS) Providers at either Emory University Hospital (EUH), Emory University Hospital Midtown (EUHM), Emory Johns Creek Hospital (EJCH), or Emory St. Joseph's Hospital (ESJH)

排除标准

  • 未提供

研究组 & 干预措施

HMS Providers

Experimental

Hospitalists will receive messages via email every 2 months with comparison data of the previous 2 months and antibiotic prescribing educational content.

HMS providers will be receiving data on prescribing as part of the intervention.

干预措施: Messaging Hospitalists (Other)

Usual Care Arm (Control)

Other

Hospitalists will receive bimonthly educational emails about simple steps to improve antibiotic prescribing.

干预措施: Usual Care (Other)

结局指标

主要结局

Observed provider-specific antibiotic prescribing rate

时间窗: Baseline and bimonthly for 2 years

The observed provider-specific antibiotic prescribing rate is defined as the billed days of therapy (DOT) of Broad-Spectrum, Hospital-Onset (BS-HO) antibiotics per 1000 billed patient-days.

次要结局

  • C. difficile infection(Up to 8 weeks post discharge (9 weeks from admission on average))
  • Number of participants with a prolonged length of initial hospital stay(Hospital stay, an average of 10 days)
  • In-hospital mortality(Hospital admission, an average of 7 days)
  • Hospital readmissions(30 days after hospital discharge)

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Scott K. Fridkin

Professor of Medicine and Epidemiology

Emory University

研究点 (4)

Loading locations...

相似试验

InPART RX - Epicenters | 临床试验