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Reducing Unnecessary Care for Traumatic Injury

N/A

Waitlist Available

Research Sponsored by Laval University

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Timeline

Screening 3 weeks

Treatment Varies

Follow Up 18-month interval (6 to 24 months) after implementation

Awards & highlights

No Placebo-Only Group

Summary

This trial will study how to reduce unnecessary tests & procedures in injury admissions, leading to improved healthcare efficiency, cost savings & reduced adverse events.

Who is the study for?

This trial is for adult trauma centers in Québec's Trauma Care Continuum, specifically levels I-III. It aims to improve care for patients hospitalized with injuries by reducing unnecessary medical procedures. Level IV centers are excluded due to low patient volumes.

What is being tested?

The study tests two approaches to reduce low-value clinical practices: usual practice with simple audit & feedback versus enhanced audit & feedback combined with educational outreach and facilitation. The goal is to see which method better reduces unnecessary tests and treatments.

What are the potential side effects?

Since this trial focuses on process improvement rather than direct patient interventions, it does not involve medications or treatments that would typically have side effects. However, changes in care processes could potentially impact patient experiences.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ 18-month interval (6 to 24 months) after implementation

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~18-month interval (6 to 24 months) after implementation

This trial's timeline: 3 weeks for screening, Varies for treatment, and 18-month interval (6 to 24 months) after implementation for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Low-value initial diagnostic imaging

Secondary study objectives

Low-value specialist consultation

Pre-transfer imaging

Repeat post-transfer imaging

Other study objectives

Complications

Hospital stay

Incremental Cost-Effectiveness Ratios

+4 more

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups

Experimental Treatment

Group I: Simple audit & feedbackExperimental Treatment1 Intervention

The control arm will receive the quality improvement intervention currently in place in the Québec Trauma Care Continuum (i.e. simple A\&F report presenting their performance compared to peers on quality indicators measuring adherence to high-value care and risk-adjusted outcomes) with the addition of quality indicators on low-value care (already planned by provincial authorities for the 2023 evaluation cycle). Simple A\&F was chosen for the control because it is standard practice in Québec and in most integrated trauma systems and the effectiveness of A\&F for de-implementation has been documented.

Group II: Audit & feedback with educational outreach and facilitationExperimental Treatment1 Intervention

The intervention includes: 1) refinement with end users, 2) an A\&F report sent to local governing authorities presenting for each practice: performance compared to peers (simple A\&F), a summary message indicating if action is required and a list of potential actions, 3) educational materials (a clinical vignette; consequences of the practice; links to practice guidelines, clinical decision rules and shared decision-making tools; a case review tool), 4) virtual educational meetings with the local trauma Medical Director, trauma program manager and data analyst, and 5) two virtual facilitation visits 2 and 4 months after the transmission of the report to support committees in preparing their action plan.

Do I qualify?Apply below to find out