Improvement of Hospital Care for Patients With Non-Hodgkin's Lymphoma
试验速览
- 阶段
- 不适用
- 入组人数
- 418
- 试验地点
- 2
- 主要终点
- Change from baseline in adherence to quality indicators for NHL care
研究概览
简要总结
The main objective of the proposed study is to assess the effectiveness, feasibility and costs of a tailored strategy (developed in accordance with the barriers found and current practice) to improve care for patients with non-Hodgkin's lymphomas (NHL), compared to a common strategy of 'audit & feedback'.
详细描述
In a previous study among 22 Dutch hospitals many gaps in the care for patients with non-Hodgkin's lymphomas (NHL) were found, compared to best evidence as described in guidelines. In a problem analysis study, barriers and facilitators for good quality of NHL-care were assessed and a tailored implementation strategy was developed, based on these findings. The proposed study aims at the effectiveness, feasibility and costs of this tailored strategy to improve quality of care for patients with an NHL in a clustered randomized controlled trial in 19 Dutch hospitals.
Multilevel regression analyses will be performed to evaluate the effectiveness of both strategies. Exposure to and experiences with the strategy elements will be analysed descriptively.
Regarding the costs, the two strategies are compared with a health care perspective. The input of resources will be assessed by collecting volumes of consumed resources and multiplying these by the price of each resource unit; the implementation process and consequently costs will be estimated by an Activity Based Costing (ABC) approach. The output will be determined by the level of adherence to the NHL quality indicators.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinical diagnosis of non-Hodgkin lymphoma
- •Diagnosed in one of the participating hospitals
- •Able to read and understand Dutch
排除标准
- 未提供
结局指标
主要结局
Change from baseline in adherence to quality indicators for NHL care
时间窗: baseline and 1 year
The effect of our interventions will be measured by means of adherence to quality indicators for optimal NHL care. The effects of the audit and feedback strategy (9 hospitals) versus the tailored strategy (9 hospitals) will be evaluated using previously developed quality indicators. These indicators for optimal NHL care were developed on the basis of evidence based guidelines, literature and opinions of clinicians about NHL care in a previous study and were validated.
次要结局
- Change from baseline in morbidity(baseline and 1 year)
- Exposure to and experiences with the interventions(after 1 year)
- Costs of the strategy and the changed care(after 1 year)
- Differences between both groups in Patient Related Outcome Measures (PROMs)(after 1 year)