Precision Feedback to Improve Health Care Quality

Study Overview
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Brief Summary
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This cluster-randomized trial will assess the effectiveness of a precision feedback service on anesthesia provider performance. The precision feedback service enhances a standard audit and feedback (A&F) email with a brief message and visual display about high-value performance information. The control arm will receive a standard one size fits most A&F email that is currently sent to anesthesia providers each month. Hypothesis: Providers receiving precision feedback will increase a) care quality for improvable measures and b) email engagement (click-through and dashboard login rates) when compared with providers receiving standard A&F emails. We will assess unintended consequences in a mixed-methods process evaluation.

Official Title
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A Scalable Service to Improve Health Care Quality Through Precision Audit and Feedback: A Cluster-randomized Controlled Trial

Conditions
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Anesthesia Care Quality

Intervention / Treatment
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* Behavioral: precision-enhanced feedback email messages
* Behavioral: standard feedback email messages


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria (assessed before interventional period): Participation in the Multicenter Perioperative Outcomes Group (MPOG) provider feedback email program. Exclusion Criteria (assessed after interventional period): Ended participation in the MPOG provider feedback email program for any reason during the study period Changed professional roles (e.g. transitioned from resident to attending) before the end of the intervention period

Ages Eligible for Study
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Minimum Age: 18 Years

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: precision-enhanced feedback email messages<br>Providers receive an enhanced monthly email containing precision audit and feedback (A&F). | Behavioral: precision-enhanced feedback email messages<br>* Providers receive customized messages prioritizing metrics in an optimal formatting.<br>|
| Active Comparator: standard feedback email messages<br>Providers receive the standard one size fits most A&F monthly email. | Behavioral: standard feedback email messages<br>* Providers receive metrics in a common format.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measure success rate (M) for operative cases of anesthesia care providers | The primary outcome for the cluster-randomized controlled trial is the measure success rate (M) for operative cases of anesthesia care providers, where: M = sum of all operative case measurement successes / number of all operative case measurements | Up to 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Average email click-through rate (CTR) | CTR = 100 x (number of recipient's emails with a clicked link) / (total number of emails) | Up to 2 years | 
| Average dashboard login rate (L) | L = 100 x (number of months with an email recipient's dashboard login event) / (total number of months) | Up to 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Audit and feedback, Anesthesiology, Learning health system