Evaluation of the Effectiveness of an Audit and Feedback Intervention With Quality Improvement Toolbox in Intensive Care

Not Applicable

Completed

• Conditions: Critical Care; Pain Management; Quality Improvement
• Interventions: Behavioral: Audit and Feedback; Behavioral: Toolbox

• Registration Number: NCT02922101
• Lead Sponsor: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Brief Summary

This study evaluates the addition of a quality improvement toolbox to an online audit and feedback intervention in Dutch intensive care units. The toolbox comprises for each quality indicator (e.g., percentage of patients per shift whose pain is measured) a list of potential bottlenecks in the care process (e.g., staff is unaware of the prevailing guidelines for measuring pain every shift), associated recommendations for actions to solve mentioned bottlenecks (e.g., organize an educational training session), and supporting materials to facilitate implementation of the actions (e.g., a slide show presentation discussing the importance and relevance of measuring pain every shift). Half of the participating intensive care units will only receive online feedback, while the other half will additionally gain access to the integrated toolbox to facilitate planning and executing actions.

Detailed Description

Not available

Study Timeline

• Study Start: 2016-09
• Study First Submitted: 2016-09-26
• Study First Submitted QC: 2016-10-03
• Study First Posted: 2016-10-04
• Primary Completion: 2018-10
• Study Completion: 2018-10
• Status Verified: 2019-01
• Last Update Submitted: 2019-01-09
• Last Update Posted: 2019-01-10

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 21

Inclusion Criteria

• ICUs treating adult (18 years and above) patients
• ICUs willing and able to submit data monthly
• ICUs with a local quality improvement team of at least 1 intensivist and 1 nurse

Exclusion Criteria

• Nil

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Audit and Feedback with toolbox	Audit and Feedback	Access to an online dashboard that provides insight into clinical performance on quality indicators for pain management; including a quality improvement toolbox to facilitate planning and executing actions. Participating ICUs will receive one educational outreach visit and brief monthly telephone calls.
Audit and Feedback without toolbox	Audit and Feedback	Same intervention, but without access to the quality improvement toolbox.
Audit and Feedback with toolbox	Toolbox	Access to an online dashboard that provides insight into clinical performance on quality indicators for pain management; including a quality improvement toolbox to facilitate planning and executing actions. Participating ICUs will receive one educational outreach visit and brief monthly telephone calls.

Primary Outcome Measures

Name	Time	Method
Change from proportion of patient shifts during which pain has been adequately managed	9 months	"Adequately managed" is defined: pain measured AND (acceptable pain score OR (unacceptable pain score AND normalized within 1 hour)). The primary outcome measure is a composite score of four quality indicators (= secondary outcome measures).The measure is limited to only patients' first 12 shifts to prevent bias from patients with a long stay. There are 3 shifts in 1 day.

Secondary Outcome Measures

Name	Time	Method
Change from proportion of patient shifts during which pain was measured at least once	9 months
Change from proportion of patient shifts during which an unacceptable pain score was measured, and pain was timely re-measured	9 months
Change from proportion of patient shifts during which an unacceptable pain score was measured, and pain was timely re-measured indicating that the pain score was normalized	9 months
Change from proportion of patient shifts during which pain was measured and no unacceptable pain scores were observed	9 months

Trial Locations

Locations (1)

National Intensive Care Evaluation foundation; 🇳🇱 Amsterdam, Noord-Holland, Netherlands