Precision Feedback for Anesthesia Care

Overseen By Zach Landis-Lewis

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Ended participation, Changed roles, Changed institutions, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if a special type of feedback email enhances the performance of anesthesia providers. One group will receive a regular monthly email, while the other will receive an upgraded version with extra tips and visuals, known as Precision Feedback. Researchers believe the upgraded emails will help providers improve care and increase their engagement with the emails. This trial suits anesthesia providers who already receive feedback emails from the Multicenter Perioperative Outcomes Group. As an unphased trial, it offers a unique opportunity for providers to enhance their skills through innovative feedback methods.

Do I need to stop my current medications for this trial?

The protocol does not specify whether you need to stop taking your current medications.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that the precision feedback service is safe for anesthesia providers?

Research has shown that precision feedback, which provides detailed feedback to anesthesia providers, is under study to determine its impact on their performance. The sources do not mention any negative side effects or safety concerns related to precision feedback. As the trial focuses on feedback methods rather than a new drug or invasive procedure, it likely poses no safety risks to participants.

Precision feedback aims to deliver helpful information in an encouraging manner. Previous studies have found it well-received, with no reports of negative effects. This suggests that participating in trials involving this feedback system is safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a new way to enhance anesthesia care through precision feedback. Unlike the standard "one size fits most" feedback, the precision-enhanced feedback provides tailored monthly emails to anesthesia providers, integrating specific audit data and feedback. This personalized approach could lead to more effective and efficient anesthesia practices, potentially improving patient outcomes and provider performance. By targeting feedback to individual needs, researchers hope to uncover insights that lead to enhanced anesthesia care and better overall healthcare experiences.

What evidence suggests that this precision feedback service is effective for improving anesthesia care?

This trial will compare precision-enhanced feedback with standard feedback for anesthesia care. Research has shown that precise feedback can improve healthcare by providing personalized information to anesthesia providers. Participants in this trial may receive precision-enhanced feedback, which studies indicate helps providers focus on areas needing improvement. This approach can lead to better care quality and increased engagement with feedback emails. Initial findings suggest that precision feedback improves performance more effectively than standard methods by offering clear, data-driven insights tailored to each provider's needs. ^{1 4 5 6 7}

Who Is on the Research Team?

Zach Landis-Lewis

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

This trial is for anesthesia providers who are already part of the MPOG provider feedback email program. It's designed to see if a more personalized feedback method can improve their performance in providing care.

Inclusion Criteria

Participation in the Multicenter Perioperative Outcomes Group (MPOG) provider feedback email program.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-intervention

Providers' baseline performance is measured for 6 months before the intervention

6 months

Intervention

Providers receive either precision-enhanced feedback or standard feedback emails monthly

6 months

Follow-up

Participants are monitored for email engagement and performance improvements

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Precision Feedback
• Standard Feedback

Trial Overview The study compares two types of email messages: precision-enhanced feedback emails with tailored content and visuals, versus standard 'one size fits most' audit and feedback emails currently used.

How Is the Trial Designed?

Group I: precision-enhanced feedback email messages Experimental Treatment 1 Intervention

Providers receive an enhanced monthly email containing precision audit and feedback (A\&F).

Group II: standard feedback email messages Active Control 1 Intervention

Providers receive the standard "one size fits most" A\&F monthly email.

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

National Library of Medicine (NLM)

Collaborator

Trials

42

Recruited

108,000+

Published Research Related to This Trial

The usability evaluation of the Performance Improvement plaN GeneratoR (PINGR) identified 47 usability issues, with the most significant problems related to 'Consistency and standards' and 'Match between system and real world', which could hinder effective use by clinicians.

The recommended actions component of PINGR had the highest number of usability issues, indicating that improvements in this area could enhance the overall effectiveness of computerized Audit and Feedback systems in primary care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interface design recommendations for computerised clinical audit and feedback: Hybrid usability evidence from a research-led system. Brown, B., Balatsoukas, P., Williams, R., et al.[2022]

The acceptance of clinical performance feedback by physicians is significantly influenced by the characteristics of the feedback itself, such as its content and timeliness, as well as the fairness of the assessment process.

Emotional responses to feedback, often stemming from the assessment process rather than the feedback content, play a crucial role in determining how physicians react and modify their patient-management behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Model depicting aspects of audit and feedback that impact physicians' acceptance of clinical performance feedback. Payne, VL., Hysong, SJ.[2018]

In a review of 146 randomized trials on audit and feedback (A&F) interventions, it was found that most feedback compared performance against benchmarks (60.3%), but only a small percentage (5.5%) provided a rationale for the chosen comparators, indicating a lack of theoretical grounding in their design.

To enhance the effectiveness of A&F, the study suggests using tailored comparisons instead of general benchmarks, limiting the number of comparators shown, and encouraging recipients to set personal targets based on relevant information, which could improve the credibility and actionability of the feedback.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical performance comparators in audit and feedback: a review of theory and evidence. Gude, WT., Brown, B., van der Veer, SN., et al.[2023]

In a study involving 40 internal medicine teams, intensive audit and feedback methods, including daily data dashboards and weekly performance reviews, significantly improved the completion of discharge metrics (79.3% vs. 63.2% in the control group, P<0.0001).

The effectiveness of the intensive feedback diminished after the intervention ended, indicating that continuous and timely feedback is crucial for maintaining improved performance in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Next-generation audit and feedback for inpatient quality improvement using electronic health record data: a cluster randomised controlled trial. Patel, S., Rajkomar, A., Harrison, JD., et al.[2019]

A review of 140 trials on audit and feedback (A&F) interventions revealed significant gaps in reporting, with clarity ranging from 56% to 97%, indicating a need for improved standardization in how these interventions are documented.

The study identified 17 modifiable elements of A&F interventions, highlighting considerable variation in their design, with 51% targeting individual providers and 92% aimed at behavior change, which may affect the overall effectiveness of A&F in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reporting and design elements of audit and feedback interventions: a secondary review. Colquhoun, H., Michie, S., Sales, A., et al.[2018]

The development of a web-based audit and feedback (A&F) dashboard for primary care was informed by user-centered design and A&F theory, incorporating input from family physicians to ensure it meets their needs.

User interviews revealed that while physicians are interested in peer comparisons, high burnout levels and a lack of motivation to improve performance were significant barriers, highlighting the need for dashboards to present data effectively and support physicians in quality improvement efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing an Audit and Feedback Dashboard for Family Physicians: User-Centered Design Process. Shuldiner, J., Kiran, T., Agarwal, P., et al.[2023]

The effectiveness of electronic audit and feedback (e-A&F) interventions in improving quality of care is highly variable, as shown by a meta-analysis of seven studies involving 81,700 patients and 329 healthcare professionals, with many studies exhibiting medium to high risk of bias.

Most e-A&F interventions targeted theoretical domains like 'knowledge', 'social influences', and 'goals', but did not comprehensively address all relevant domains, indicating a need for future research to better understand which theoretical factors are crucial for enhancing the effectiveness of e-A&F interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of electronic audit and feedback: intervention effectiveness and use of behaviour change theory. Tuti, T., Nzinga, J., Njoroge, M., et al.[2023]

The study aims to implement a precision audit and feedback (A&F) system in anesthesia care, which tailors performance feedback to individual providers based on their specific needs and performance gaps, potentially improving care quality and outcomes.

Conducted with over 60 hospitals in a national consortium, the study will evaluate the effectiveness of this precision A&F approach through a cluster randomized controlled trial, with data collection starting in March 2022 and the intervention phase beginning in March 2024.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Scalable Service to Improve Health Care Quality Through Precision Audit and Feedback: Proposal for a Randomized Controlled Trial. Landis-Lewis, Z., Flynn, A., Janda, A., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11185285/

Exploring Anesthesia Provider Preferences for Precision ... A scalable service to improve health care quality through precision audit and feedback: proposal for a randomized controlled trial. JMIR Res ...

2. researchprotocols.org researchprotocols.org/2022/5/e34990

A Scalable Service to Improve Health Care Quality ... This study aims to implement and evaluate a demonstration system for precision A&F in anesthesia care and to assess the effect of precision feedback emails on ...

3. withpower.com withpower.com/trial/phase-anesthesia-care-quality-2-2024-bec70

Precision Feedback for Anesthesia Care · Info for Participants This cluster-randomized trial will assess the effectiveness of a precision feedback service on anesthesia provider performance. The precision feedback ...

4. researchgate.net researchgate.net/publication/360526016_A_Scalable_Service_to_Improve_Health_Care_Quality_Through_Precision_Audit_and_Feedback_Proposal_for_a_Randomized_Controlled_Trial

(PDF) A Scalable Service to Improve Health Care Quality ... Objective: This study aims to implement and evaluate a demonstration system for precision A&F in anesthesia care and to assess the effect of precision feedback ...

5. turkjanaesthesiolreanim.org turkjanaesthesiolreanim.org/articles/precision-anaesthesia-advancing-patient-centered-precision-care-through-repetitive-assessment-of-proms-with-the-safe-brain-initiative-approach/TJAR.2023.231420

Precision Anaesthesia: Advancing Patient-Centered Precision ... By providing healthcare providers anonymous feedback regarding their patients' outcome metrics, they can actively involve patients in their care ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9131150/

A Scalable Service to Improve Health Care Quality ... This study aims to implement and evaluate a demonstration system for precision A&F in anesthesia care and to assess the effect of precision feedback emails on ...

7. mededu.jmir.org mededu.jmir.org/2024/1/e54071/PDF

Exploring Anesthesia Provider Preferences for Precision ... A scalable service to improve health care quality through precision audit and feedback: proposal for a randomized controlled trial. JMIR Res ...