The Multiple Sclerosis Continuous Quality Improvement (MSCQI) Collaborative
- Conditions
- Multiple Sclerosis
- Interventions
- Other: Quality Improvement
- Registration Number
- NCT03480854
- Lead Sponsor
- Dartmouth-Hitchcock Medical Center
- Brief Summary
To establish the first systems level continuous quality improvement (CQI) collaborative for multiple sclerosis (MS) in the United States, to conduct benchmarking analyses and assessments of geographic variation in MS care quality and value, and study the effect of CQI interventions on improvement of selected performance (quality) indicators.
- Detailed Description
This is a three year study which employed a step-wedge randomized design which exposed three of four participating centers to a healthcare QI intervention during the 3 year period. Each of the centers exposed to an intervention served as its own control during a baseline pre-intervention period during the first year of the study. The fourth site served as a longitudinal control for comparison to the other three centers exposed to a QI intervention.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 694
- Adults aged 18 years or older with documented clinically confirmed MS who are followed by one of the participating MS centers.
- Candidates will be excluded from study entry if they are unable or unwilling to provide informed consent.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description The effect of continuous quality improvements (CQI) Quality Improvement To study the comparative improvement of selected primary process performance indicators (DMT and MRI process measures) over a 3 year period (Years 2-3) in microsystems receiving CQI interventions versus those not receiving CQI intervention, and between two different CQI intervention types (IHI Breakthrough Series and Patient Centered Medical Home).
- Primary Outcome Measures
Name Time Method Disease modifying therapy utilization every 12 weeks for a period of 36 months The percentage of eligible MS patients on disease modifying therapy (DMT access), which is operationally defined as the total number of eligible patients on DMT/the total number of patients seen per quarter at a participating center for whom DMT is an appropriate treatment option.
- Secondary Outcome Measures
Name Time Method Clinic Outcome for Anxiety every 12 weeks for a period of 36 months patient reported outcome of Neuro-QOL: Anxiety survey
Clinic Outcomes for Vitamin D levels in MS patients every 12 weeks for a period of 36 months patient reported outcome of Vitamin D Level survey
Clinic Outcomes for fatigue every 12 weeks for a period of 36 months patient reported outcome of PROMIS Fatigue MS survey
Clinic Outcomes for the effects of MS on the patient every 12 weeks for a period of 36 months patient reported outcome of The Effects of Your MS (PDDS) survey
Clinic Outcomes for the presence of a MS relapse every 12 weeks for a period of 36 months patient reported outcome of My MS Relapse Evaluation survey
Clinic Outcomes for satisfaction of treatment by medication every 12 weeks for a period of 36 months patient reported outcome of Treatment Satisfaction Questionnaire for Medication (TSQM-9) survey
Clinical outcome for Depression every 12 weeks for a period of 36 months patient reported outcome of The Effects of Your MS (PHQ-9)
Clinic Outcomes on stigma associated with MS every 12 weeks for a period of 36 months patient reported outcome of Neuro-QOL: Stigma survey
Clinic Outcomes on Cognitive Function every 12 weeks for a period of 36 months patient reported outcome of Neuro-QOL: Cognitive Function survey
Clinic Outcomes on fine motor skills and activities of daily living every 12 weeks for a period of 36 months patient reported outcome of Neuro-QOL: Upper Extremity Function (Fine Motor, ADL) survey
Clinic Outcomes on ability to participate in social roles and activities every 12 weeks for a period of 36 months patient reported outcome of Neuro-QOL: Ability to Participate in Social Roles and Activities survey
Clinic Outcomes reporting of MS patient daily symptoms every 12 weeks for a period of 36 months patient reported outcome of the Daily Symptoms survey
Medical History every 12 weeks for a period of 36 months data regarding medical history reported by the patient
MRI utilization every 12 weeks for a period of 36 months survey data regarding number of MRIs reported by the patient
Clinic Outcomes for communication every 12 weeks for a period of 36 months patient reported outcome of Neuro-QOL: Communication survey
Hospitalization every 12 weeks for a period of 36 months data regarding hospitalization reported by the patient
Clinic Outcomes on mobility every 12 weeks for a period of 36 months patient reported outcome of Neuro-QOL: Lower Extremity Function (Mobility) survey
Clinic Outcomes on satisfaction with social roles and activities every 12 weeks for a period of 36 months patient reported outcome of Neuro-QOL: Satisfaction with Social Roles and Activities survey
Clinic Outcomes for sleep disturbance every 12 weeks for a period of 36 months patient reported outcome of Neuro-QOL: Sleep Disturbance survey
Clinic Outcomes for assesment of patient health status every 12 weeks for a period of 36 months patient reported outcome of Brief Appraisal Inventory survey
Demographic information every 12 weeks for a period of 36 months data regarding demographics reported by the patient
Exercise collected daily and summarized annually. survey data regarding daily exercise
System level measure of Health Care Quality every 12 weeks for a period of 36 months Patient determined disease steps survey
Medication every 12 weeks for a period of 36 months survey data regarding medication use reported by the patient
System level measure the patient experience for ambulatory care. every 12 weeks for a period of 36 months Health care quality assessment collected through the Aggregated Clinician and Group Survey to assess patient experience in ambulatory care.
Trial Locations
- Locations (4)
Massachusetts General Hospital Multiple Sclerosis Center
🇺🇸Boston, Massachusetts, United States
Concord Hospital
🇺🇸Concord, New Hampshire, United States
University of Vermont Multiple Sclerosis Center
🇺🇸Burlington, Vermont, United States
Neurology Associates of Greater Orlando
🇺🇸Maitland, Florida, United States