Health Care Appropriateness Assessment and Support Programme at a University Hospital Centre (CHU) in Bordeaux
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 63
- 试验地点
- 1
- 主要终点
- Global proportion of patient stays appropriate regarding health cares concerned with feedback indicators available at the start of the trial.
研究概览
简要总结
Non-appropriateness of care is a common and serious phenomenon that affects healthcare institutions in France. Appropriateness in health care is about adequacy of any type of health care with patient's needs. Relying on structuring innovative tools, the hospital university centre of Bordeaux is implementing a health care appropriateness assessment and support programme ("sPREAd pertinence").
By using a mixed method, the project's main objective is to evaluate programme effectiveness on the improvement of care appropriateness in hospital university centre of Bordeaux. Other assessments are considering impact on: specific care appropriateness indicators, care related adverse events frequency, organizational climate, and work life satisfaction. The economic impact of this program in terms of induced costs and avoided costs will be evaluated. A qualitative approach will be used to identify the programme transferability conditions with a view to produce an Operational Model for the Implementation of Appropriateness at a Healthcare Institution.
详细描述
Non-appropriateness of care is a common and serious phenomenon that affects healthcare institutions in France. Appropriateness in health care is about adequacy of any type of health care with patient's needs. It means that a health care is necessary and relevant, given a specific indication, with regard to updated practice recommendations or justifications of experts.
The hospital university centre of Bordeaux is making Health care appropriateness a policy priority. Relying on structuring innovative tools, it is implementing a health care appropriateness assessment and support programme ("sPREAd pertinence"). This programme comprises two parts, one regarding interventional aspects and the other concerning assessments.
sPREAd-Pertinence programme's objectives Project's primary objective is to evaluate programme effectiveness on the improvement of care appropriateness in hospital university centre of Bordeaux.
Project's secondary objectives are :
- to assess impact on specific care appropriateness indicators, care related adverse events frequency, organizational climate and work life satisfaction.
- to evaluate the actual use of GAP.
- to measure the costs of implementing the sPREAD Perti program and to identify the additional costs incurred in comparison with the mobilization and support approach to care appropriateness already existing at the Bordeaux University Hospital;
- to compare the costs of the program with the consequences observed in terms of specific care appropriateness improvement, changes in serious adverse events frequency, organizational work climate and work life satisfaction;
- to estimate, if necessary, in terms of avoided costs, the reduction of serious adverse events frequency.
- to identify, using a qualitative approach:
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Retrospective
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
- •Services: services of the non-transversal clinical departments of the Bordeaux University Hospital.
- •Health professionals: Medical and paramedical professionals working during the day or night in the participating services for at least one month and at least one day per week.
- •Patients: Stays of patients hospitalized at the Bordeaux University Hospital benefiting from care targeted by the automated indicators and made available by the feedback system at the start of the trial.
排除标准
- •Services of the transversal and medico-technical departments (Medical Imaging department, Biology and Pathology department, Health Products department, Public Health department and Anesthesia-Intensive care department) and department with specific activity.
- •Professionals: planning to be absent during the data collection period.
- •Patients: none
研究组 & 干预措施
Intervention group
Services of the non-transversal clinical departments of the Bordeaux University Hospital willing to participate to the programme.
干预措施: Intervention (Other)
Control group
Services of the non-transversal clinical departments of the Bordeaux University Hospital not willing to participate to the programme.
结局指标
主要结局
Global proportion of patient stays appropriate regarding health cares concerned with feedback indicators available at the start of the trial.
时间窗: Primary outcome is assessed 14 months after the start of the intervention
This proportion is calculated by dividing the number of appropriate patient stays for all indicators corresponding to targeted health care by the number of patients who received targeted health care for at least one of the indicators.
次要结局
- Appropriate stays proportion specific to each feedback indicator available at the start of the trial(two months before and fourteen months after applying the programme in the first cluster.)
- Dimension Scores of the Comet questionnaire(two months before and fourteen months after applying the programme in the first cluster.)
- Incidence density of serious adverse events(two months before and fourteen months after applying the programme in the first cluster.)
- Work life satisfaction(two months before and fourteen months after applying the programme in the first cluster.)