PAINED: Project Addressing INequities in the Emergency Department

Not Applicable

Recruiting

• Conditions: Fractures, Bone; Appendicitis; Pain; Bias, Racial
• Interventions: Behavioral: Department-level audit and feedback and electronic health record-embedded clinical decision support

• Registration Number: NCT05488080
• Lead Sponsor: Children's National Research Institute

Brief Summary

Racial and ethnic inequities in health care quality have been described across a broad range of clinical settings, patient populations, and outcomes. Our overarching goal is to eradicate health care inequities through evidence-based interventions. The objectives of this proposal are to develop and test the impact of two interventions on overcoming clinician implicit bias and mitigating inequities in the management of pain among children seeking care in the emergency department for the treatment of appendicitis or long bone fractures.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2022-07-15
• Study First Submitted QC: 2022-08-03
• Study First Posted: 2022-08-04
• Study Start: 2023-02-27
• Status Verified: 2024-07
• Last Update Submitted: 2024-07-18
• Last Update Posted: 2024-07-22
• Primary Completion: 2026-08-01
• Study Completion: 2026-08-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 300

Inclusion Criteria

• All Children's National Hospital Emergency Department clinicians

Exclusion Criteria

• None

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Department-level audit and feedback and electronic health record-embedded clinical decision support	Department-level audit and feedback and electronic health record-embedded clinical decision support	Clinicians will receive monthly pooled, department-level 'Equity Report Cards' that will provide aggregate information on clinical data stratified by patient race/ethnicity. Subsequently, for all visits that may be related to appendicitis or long bone fracture, clinicians will then receive real-time, electronic health record-embedded clinical decision support regarding pain management.

Primary Outcome Measures

Name	Time	Method
Pain reduction	Equity Report Cards provided monthly to clinicians over a 24-month period	Percentage of patients with pain reduction, pain is measured on a 0 to 10 scale, 0 is the minimum and 10 is the maximum, a lower score is a better outcome.
Analgesia use	Equity Report Cards provided monthly to clinicians over a 24-month period	Rate of analgesia use

Trial Locations

Locations (1)

Children's National Hospital; 🇺🇸 Washington, District of Columbia, United States