Systematic Quality Improvement With Realtime Event Support

Not Applicable

Completed

• Conditions: Telemedicine
• Interventions: Other: Telemedicine intervention

• Registration Number: NCT04983329
• Lead Sponsor: Washington University School of Medicine

Brief Summary

The goal of this study is to improve perioperative quality metric performance in patients receiving anesthesia care provided by Washington University Department of Anesthesiology. In this protocol, we describe (1) the use of telemedicine-augmented quality improvement interventions to enhance on-time dosage of surgical prophylactic antibiotics, while (2) carrying out large scale monitoring of surgical site infection incidence in the target population. If this quality improvement framework is found to be feasible and successful, we plan subsequently to study its application to additional perioperative quality metrics, including many pertinent to surgical site infection incidence such as perioperative glucose monitoring and management, and intraoperative temperature management.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2021-07-16
• Study First Submitted QC: 2021-07-29
• Study First Posted: 2021-07-30
• Study Start: 2021-11-08
• Primary Completion: 2022-06-12
• Study Completion: 2022-09-10
• Status Verified: 2023-04
• Last Update Submitted: 2023-04-26
• Last Update Posted: 2023-04-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 25506

Inclusion Criteria

• Patients having procedures at Barnes-Jewish Hospital in suites not part of the TECTONICS trial will be included.

Exclusion Criteria

• Patients enrolled in the ongoing TECTONICS intraoperative Anesthesiology Control Tower telemedicine trial at Barnes-Jewish Hospital will be excluded from this study

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Improvement in administration of surgical antibiotic prophylaxis.	Telemedicine intervention	The eight-month module will include a baseline phase, educational interventions, real-time guidance from a remote telemedicine center, regular feedback regarding adherence to protocols related to that module, and continued silent monitoring.

Primary Outcome Measures

Name	Time	Method
Improvement in administration of surgical antibiotic prophylaxis-after quality improvement intervention	2 months	1b. Increase the rate of on-time surgical antibiotic prophylaxis administration prior to incision six weeks after the quality improvement intervention is completed.
Improvement in administration of surgical antibiotic prophylaxis- intervention period	3 months	1a. Increase the rate of on-time surgical antibiotic prophylaxis administration prior to incision during the intervention period.
Improvement in administration of surgical antibiotic prophylaxis	8 months	1c. Increase the rate of on-time re-dosing of antibiotic prophylaxis throughout the duration of the trial.

Secondary Outcome Measures

Name	Time	Method
Surgical site infection rate	8 months	Decrease the proportion of patients which develop surgical site infections throughout the duration of the trial.

Trial Locations

Locations (1)

Washington University School of Medicine/Barnes Jewish Hospital; 🇺🇸 Saint Louis, Missouri, United States