CT C-spine Audit and Feedback

Not Applicable

Completed

• Conditions: Emergencies; Cervical Spine Injury; Trauma
• Interventions: Behavioral: Audit and Feedback on Individual Practice Patterns

• Registration Number: NCT05711134
• Lead Sponsor: University of Massachusetts, Worcester

Brief Summary

This is a prospective quality improvement study to assess the effect of using an audit-and-feedback process for emergency providers on utilization of computed tomography of the cervical spine. The objective of this study is to determine whether providing repeated individualized feedback on CT C-spine utilization to emergency providers alters their practice pattern and reduces overutilization. The investigators hypothesize that emergency providers who receive individualized feedback regarding their CT C-spine utilization on a regular basis will alter their practice pattern to reduce overutilization of this imaging study.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-01-24
• Study First Submitted QC: 2023-01-24
• Study First Posted: 2023-02-02
• Study Start: 2023-05-01
• Primary Completion: 2023-10-31
• Study Completion: 2023-10-31
• Status Verified: 2023-11
• Last Update Submitted: 2023-11-06
• Last Update Posted: 2023-11-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

• Emergency medicine physician, nurse practitioner, or physician assistant
• Ordered at least 5 CT scans of the cervical spine on adult patients in the two-month pre-intervention period

Exclusion Criteria

• Non-emergency providers
• Ordered few than 5 studies in the pre-intervention period

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Serial In-Person Feedback	Audit and Feedback on Individual Practice Patterns	Providers are given recurring individualized in-person feedback on their practice patterns.
In-Person Feedback with Serial Electronic Feedback	Audit and Feedback on Individual Practice Patterns	Providers are given one-time individualized in-person feedback on their practice patterns, followed by recurrent individualized electronic feedback.

Primary Outcome Measures

Name	Time	Method
Percent NEXUS-Negative	6 months	Percentage of CT C-spine studies that an individual provider ordered on NEXUS-negative patients

Secondary Outcome Measures

Name	Time	Method
Number of Fractures	6 months	Number of cervical spine fractures identified on CT for patients who are NEXUS-negative
Number of CTs	6 months	Number of CT scans of the cervical spine ordered by each provider
Clinically Significant Fractures	6 months	Number of cervical spine fractures identified on CT for patients who are NEXUS-negative that required procedural intervention, hospitalization, or prolonged immobilization

Trial Locations

Locations (1)

University of Massachusetts Chan Medical School; 🇺🇸 Worcester, Massachusetts, United States