Clinical trial NCT02922101: Evaluation of the Effectiveness of an Audit and Feedback Intervention With Quality Improvement Toolbox in Intensive Care
Official title: Increasing the Effectiveness and Understanding of Audit and Feedback Interventions in Intensive Care: Protocol for a Mixed-methods Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Pain Management
Critical Care
Quality Improvement
Lead sponsor: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Sponsor class: OTHER
Collaborators: name: National Intensive Care Evaluation Foundation
First posted: 2016-10-04
Enrollment: 21
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This study evaluates the addition of a quality improvement toolbox to an online audit and feedback intervention in Dutch intensive care units. The toolbox comprises for each quality indicator (e.g., percentage of patients per shift whose pain is measured) a list of potential bottlenecks in the care process (e.g., staff is unaware of the prevailing guidelines for measuring pain every shift), associated recommendations for actions to solve mentioned bottlenecks (e.g., organize an educational training session), and supporting materials to facilitate implementation of the actions (e.g., a slide show presentation discussing the importance and relevance of measuring pain every shift). Half of the participating intensive care units will only receive online feedback, while the other half will additionally gain access to the integrated toolbox to facilitate planning and executing actions.


Eligibility criteria: Inclusion Criteria:

* ICUs treating adult (18 years and above) patients
* ICUs willing and able to submit data monthly
* ICUs with a local quality improvement team of at least 1 intensivist and 1 nurse

Exclusion Criteria:

* Nil

Primary outcomes:
measure: Change from proportion of patient shifts during which pain has been adequately managed
timeFrame: 9 months
Secondary outcomes:
measure: Change from proportion of patient shifts during which pain was measured at least once
timeFrame: 9 months
measure: Change from proportion of patient shifts during which pain was measured and no unacceptable pain scores were observed
timeFrame: 9 months
measure: Change from proportion of patient shifts during which an unacceptable pain score was measured, and pain was timely re-measured
timeFrame: 9 months
measure: Change from proportion of patient shifts during which an unacceptable pain score was measured, and pain was timely re-measured indicating that the pain score was normalized
timeFrame: 9 months
Other outcomes:
Locations:
city: Amsterdam
country: Netherlands
facility: National Intensive Care Evaluation foundation
state: Noord-Holland
Study officials:
affiliation: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
name: Nicolette F de Keizer, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Gude WT, Roos-Blom MJ, van der Veer SN, Dongelmans DA, de Jonge E, Peek N, de Keizer NF. Facilitating action planning within audit and feedback interventions: a mixed-methods process evaluation of an action implementation toolbox in intensive care. Implement Sci. 2019 Sep 18;14(1):90. doi: 10.1186/s13012-019-0937-8.
citation: Roos-Blom MJ, Gude WT, de Jonge E, Spijkstra JJ, van der Veer SN, Peek N, Dongelmans DA, de Keizer NF. Impact of audit and feedback with action implementation toolbox on improving ICU pain management: cluster-randomised controlled trial. BMJ Qual Saf. 2019 Dec;28(12):1007-1015. doi: 10.1136/bmjqs-2019-009588. Epub 2019 Jul 1.
citation: Gude WT, Roos-Blom MJ, van der Veer SN, Dongelmans DA, de Jonge E, Francis JJ, Peek N, de Keizer NF. Health professionals' perceptions about their clinical performance and the influence of audit and feedback on their intentions to improve practice: a theory-based study in Dutch intensive care units. Implement Sci. 2018 Feb 17;13(1):33. doi: 10.1186/s13012-018-0727-8.
citation: Gude WT, Roos-Blom MJ, van der Veer SN, de Jonge E, Peek N, Dongelmans DA, de Keizer NF. Electronic audit and feedback intervention with action implementation toolbox to improve pain management in intensive care: protocol for a laboratory experiment and cluster randomised trial. Implement Sci. 2017 May 25;12(1):68. doi: 10.1186/s13012-017-0594-8.