A Cluster Controlled Trial Comparing Three Methods of Disseminating Practice
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 发起方
- 主要终点
- Rate of hospital days per 1,000 disease episodes
研究概览
简要总结
The purpose of this study is to identify, from a societal perspective, the costs and associated benefits of three strategies for disseminating and implementing a practice guideline that addresses the management of croup.
详细描述
Overall Aim: The overall aim of this study is to identify - from a societal perspective - the costs and associated benefits of three strategies for implementing a practice guideline that addresses the management of croup.
Intervention Strategies: The intervention strategies to be compared will be mailing of printed educational materials (the "Standard intervention"), mailing plus a combination of interactive educational meetings, educational outreach visits, and reminders (a "Saturn intervention"), and a combination of mailing, interactive sessions, outreach visits, reminders plus identification of local opinion leaders and establishment of local consensus processes (a "Cadillac intervention").
Primary Objective: To determine which of the three intervention strategies are most effective at lowering the rate of hospital days per 1,000 disease episodes. The null hypothesis is that none of the intervention strategies reduce hospital utilization rates from baseline. The alternate hypothesis is that the intervention strategies will have a graded degree of effect on hospitalization rates, with the 'Standard intervention' having minimal to no effect, the 'Saturn intervention' having moderate but significant effect, and the 'Cadillac intervention' having the greatest effect.
Secondary Objective: To determine which of the three dissemination strategies are most effective at increasing the use of therapies of known benefit.
Economic Analysis: To determine which of the three intervention strategies will most effectively reduce total societal costs including all health care costs, costs borne by the family, and costs stemming from the strategies for disseminating guidelines.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Educational Counseling Training
- 盲法
- None
入排标准
- 年龄范围
- 0 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Alberta hospitals were rank ordered based on the number of disease episodes and rates of hospitalization for a six-year period. We then approached in this order each of the hospital administrators and clinical staff for permission to include their hospital in our study until a total of 24 hospitals consented
排除标准
- •Refusal by hospital staff to participate in this trial
结局指标
主要结局
Rate of hospital days per 1,000 disease episodes
次要结局
- Proportion of patients evaluated in ED for at least three hours after treatment with corticosteroids before the decision to admit to hospital is made.
- Time to treatment with corticosteroids in both ED and hospital patients.
- Proportion of patients treated in the ED and hospital with a corticosteroid.
- An economic analysis conducted from a societal perspective with costs classified as either payer (costs born by the province) or non-payer (costs born by individuals or the families of children with croup).