Nudging Provider Adoption of Clinical Decision Support: Implementation of an EHR-Agnostic Pulmonary Embolism Risk Prediction Tool
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 440
- 试验地点
- 3
- 主要终点
- Percentage of CT scan orders that are guideline-concordant
研究概览
简要总结
The purpose of this study is to examine the impact of the nudge implementation strategy (CDS tool + Nudge) on adoption of guideline-concordant CT ordering for pulmonary embolism (PE) in 10 EDs. The study will be a 33-month, rigorous, pragmatic, cluster-randomized, stepped wedge trial across 3 health systems and 10 EDs after collecting pre-implementation baseline data. The aim is to to demonstrate technological feasibility as well as examine efficacy of the nudges on adoption. The secondary objective is to decrease CT-ordering when it is not indicated.
详细描述
Part 1 of the study included the collection of data. During the pre-implementation period each sites electronic health record (EHR) and baseline data was collected for 12 months. In Part 2, the study will examine the impact of the nudge implementation strategy (CDS tool + Nudge) on adoption of guideline-concordant CT ordering for PE in 10 EDs. Adoption outcomes data will be collected through EHR reporting systems.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Supportive Care
- 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
- 是
入选标准
- •18 years of older
- •A provider (MD, NP, PA) ordering CTs for evaluation of PE in adult patients present at study site Emergency Department (i.e., Northwell Health - Feinstein Institute for Medical Research, Baylor College of Medicine and NYU Langone Health).
排除标准
- •1. A provider not present at the specified study sites.
研究组 & 干预措施
Emergency Department (ED) Providers
Each ED will serve as its own control. Baseline data will be collected for 12 months prior to the implementation of the CDS system with nudges. The CDS tool with nudges will then be implemented for 33 months.
干预措施: Clinical Decision Support (CDS) tool with Nudges (Behavioral)
结局指标
主要结局
Percentage of CT scan orders that are guideline-concordant
时间窗: Baseline (Month 12)
Guideline-concordant is defined as CT scan orders with Wells' Score \>4 \["PE Likely"\] and/or d-dimer above upper limit of normal.
Percentage of CT scan orders that are guideline-concordant
时间窗: End of intervention (Month 45)
Guideline-concordant is defined as CT scan orders with Wells' Score \>4 \["PE Likely"\] and/or d-dimer above upper limit of normal.
次要结局
未报告次要终点