Clinical trial NCT06465667: Improving Engagement With a Process Measure Dashboard Through Precision Feedback
Official title: Improving Engagement With a Process Measure Dashboard Through Precision Feedback
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Behavior
Keywords: Ureteral stent omission
Ureteral stent placement
Behavior change
Dashboard
Precision feedback
Lead sponsor: University of Michigan
Sponsor class: OTHER
First posted: 2024-06-20
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: This is be a stepped wedge randomized controlled trial of precision feedback. One hundred urologists will be randomized into four groups, stratified by case volume. The trial will consist of four steps of three months each, at the beginning of which one group will cross over from control to intervention arm. This is preceded by a three-month pre-rollout period, comprising a total study length of 15 months. The duration of the trial was chosen based on a desire to deliver "rapid" results to inform the scale-up of the intervention, and to mirror the period of time over which a typical dashboard project may be conceived, designed, and delivered. Case volume may predict dashboard engagement, stenting practices, and privileged awareness of ongoing study efforts, and is therefore suitable for stratification.
Primary purpose: OTHER

Brief summary: The study seeks to assess the impact of e-mailing specific, targeted, practice-pattern based information ("precision feedback") on provider engagement with a dashboard for a quality process measure (showing stent omission after pre-stented ureteroscopy), compared with generic information ("one size fits most" feedback).

Detailed description: The Michigan Urological Surgery Improvement Collaborative (MUSIC) is a state-wide, physician-led quality improvement collaborative comprised of over 40 urology practices representing varied practice sites within Michigan and nationally, designed to evaluate and improve the quality of urologic care.

A recently identified area for quality improvement within MUSIC is avoidance of placing ureteral stents following uncomplicated ureteroscopy and lithotripsy for kidney stones. Such unnecessary stents do not measurably increase post-operative safety, but rather have been shown to contribute to unnecessary emergency department visits. This process measure (stent omission after uncomplicated ureteroscopy) is the subject matter for the dashboard and will serve as the focus of precision feedback.

The study team hypothesizes that a behavior change intervention bundle consisting of "precision feedback" along with communication strategies to simplify access to feedback will increase dashboard engagement (measured via click-through rate and dashboard logins) compared with standard "one size fits most" e-mail messages. Knowledge gained from this study will inform the development of other precision feedback programs within our urology quality improvement collaborative (MUSIC), and provide a framework for rapid, pragmatic trials for small to mid-sized collaborative quality initiatives nationally.

Eligibility criteria: Inclusion Criteria:

-Urologists participating in MUSIC that were in the top one hundred individuals in annual case volume from 2023 for "pre-stented ureteroscopy", the case for which the dashboard contents are most relevant.

Exclusion Criteria:

- Urologists that are not in the top one hundred individuals in annual "pre-stented ureteroscopy" case volume, urologists in the study team, or that opt out from the study at the individual or site level.

Primary outcomes:
measure: Clickthrough rate to the online dashboard
timeFrame: Every 3 months up to 15 months
Secondary outcomes:
measure: Total number of dashboard visits
timeFrame: 15 months
measure: Cumulative time (minutes) spent on the dashboard
timeFrame: 15 months
measure: Urologist opt-out rate
timeFrame: 15 months
measure: Helpful/not helpful rate
timeFrame: 15 months
measure: Stent rate for pre-stented ureteroscopy
timeFrame: 15 months
measure: E-mail open rate
timeFrame: Every 3 months up to 15 months
Other outcomes:
Locations:
city: Ann Arbor
country: United States
facility: University of Michigan
state: Michigan
Study officials:
affiliation: University of Michigan
name: Kristian Stensland, MD
role: PRINCIPAL_INVESTIGATOR
References: