Post-Endoscopic Infection Rate Notifications to Improve the Delivery of Care

Study Overview
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Brief Summary
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This project will notify centers of center's post-endoscopic infection rates and evaluate the effectiveness of this notification system to decrease infection rates. The investigators aim to notify centers of the number of patients and center's risk-adjusted rates of hospitalizations for infections after colonoscopy and esophagogastroduodenoscopy (EGD) procedures performed between January 2015 and September 2018. The investigators will randomize centers to two notification groups: (1) Ability to view center's rate compared with all other centers (ASCs and outpatient centers notified and compared separately) or (2) Ability to view center's rate compared with the other centers with a similar patient comorbidity profile and in addition to viewing option 1. Facilities will answer questions about center's infection control practices. The investigators hypothesize that centers with high rates of post-procedural infections will (1) be more likely to report that the center took action to investigate the center's infection control practices after the first notification and (2) observe a decrease in infections after the notification. The investigators anticipate that centers with high rates of post-procedural infections that are randomized to group 2 will have greater change. The investigators anticipate no change in rates of infection in the facilities that had zero or very low (n=1) event rates.

Official Title
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Post-Endoscopic Infection Rate Notifications to Improve the Delivery of Care

Conditions
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Infection

Intervention / Treatment
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* Other: Option 1: National comparison
* Other: Option 2: National comparison with benchmarking


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Facilities that bill to fee for service Medicare for gastrointestinal endoscopy Exclusion Criteria: -
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: National comparison<br>Ability to view center's rate compared with all others | Other: Option 1: National comparison<br>* Ability to view center's rate compared with all others.<br>|
| Other: National comparison with benchmarking<br>Ability to view center's rate compared with the others with a similar patient comorbidity profile and in addition to viewing option 1 | Other: Option 2: National comparison with benchmarking<br>* Ability to view center's rate compared with the others with a similar patient comorbidity profile and in addition to viewing option 1.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the infection rate among centers with elevated infection rates |  | Baseline, 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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EGD, colonoscopy, endoscopy, ASC, outpatient, infection, Endoscopic procedures