Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| US-MSG-15-10917 | Other Grant/Funding Number | Biogen |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| MGH Multiple Sclerosis Clinic | UNKNOWN |
| University of Vermont | OTHER |
| Neurology Associates Multiple Sclerosis Center of Greater Orlando | UNKNOWN |
Not provided
Not provided
Not provided
Not provided
To establish the first systems level continuous quality improvement (CQI) collaborative for multiple sclerosis (MS) in the United States, to conduct benchmarking analyses and assessments of geographic variation in MS care quality and value, and study the effect of CQI interventions on improvement of selected performance (quality) indicators.
This is a three year study which employed a step-wedge randomized design which exposed three of four participating centers to a healthcare QI intervention during the 3 year period. Each of the centers exposed to an intervention served as its own control during a baseline pre-intervention period during the first year of the study. The fourth site served as a longitudinal control for comparison to the other three centers exposed to a QI intervention.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Baseline Analysis | No Intervention | To conduct studies of variation in performance across microsystems and to utilize benchmarking analyses to identify top performers. | |
| The effect of continuous quality improvements (CQI) | Experimental | To study the comparative improvement of selected primary process performance indicators (DMT and MRI process measures) over a 3 year period (Years 2-3) in microsystems receiving CQI interventions versus those not receiving CQI intervention, and between two different CQI intervention types (IHI Breakthrough Series and Patient Centered Medical Home). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quality Improvement | Other | Randomly selected sites will receive one of two system level improvement approaches; 1) patient centered specialty medical home certification 2) IHI Breakthrough Series improvement approach with professional improvement coaching. |
| Measure | Description | Time Frame |
|---|---|---|
| Disease modifying therapy utilization | The percentage of eligible MS patients on disease modifying therapy (DMT access), which is operationally defined as the total number of eligible patients on DMT/the total number of patients seen per quarter at a participating center for whom DMT is an appropriate treatment option. | every 12 weeks for a period of 36 months |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical outcome for Depression | patient reported outcome of The Effects of Your MS (PHQ-9) | every 12 weeks for a period of 36 months |
| Clinic Outcome for Anxiety | patient reported outcome of Neuro-QOL: Anxiety survey |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Brant J Oliver, PhD | Dartmouth Hitchock | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Neurology Associates of Greater Orlando | Maitland | Florida | 32751 | United States | ||
| Massachusetts General Hospital Multiple Sclerosis Center |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| ID | Term |
|---|---|
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D058996 | Quality Improvement |
| ID | Term |
|---|---|
| D004738 | Engineering |
| D013676 | Technology, Industry, and Agriculture |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
Not provided
Not provided
| Concord Hospital |
| OTHER |
This is a two-part prospective study to be conducted over 3 years with option to extend to 5 years. In Year 1, we will gather baseline performance data from participating MS clinics (microsystems), create a combined MSCQI systems-level database, and conduct analyses of performance variation and benchmarking. In the second part of the study (Years 2-3), we will investigate the effect of Continuous Quality Improvement interventions on primary endpoints and selected secondary measures.
Not provided
Not provided
Not provided
Not provided
| every 12 weeks for a period of 36 months |
| Clinic Outcomes on Cognitive Function | patient reported outcome of Neuro-QOL: Cognitive Function survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes on mobility | patient reported outcome of Neuro-QOL: Lower Extremity Function (Mobility) survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes on fine motor skills and activities of daily living | patient reported outcome of Neuro-QOL: Upper Extremity Function (Fine Motor, ADL) survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes on stigma associated with MS | patient reported outcome of Neuro-QOL: Stigma survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes on ability to participate in social roles and activities | patient reported outcome of Neuro-QOL: Ability to Participate in Social Roles and Activities survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes on satisfaction with social roles and activities | patient reported outcome of Neuro-QOL: Satisfaction with Social Roles and Activities survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes for sleep disturbance | patient reported outcome of Neuro-QOL: Sleep Disturbance survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes for communication | patient reported outcome of Neuro-QOL: Communication survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes for Vitamin D levels in MS patients | patient reported outcome of Vitamin D Level survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes for fatigue | patient reported outcome of PROMIS Fatigue MS survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes for assesment of patient health status | patient reported outcome of Brief Appraisal Inventory survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes for satisfaction of treatment by medication | patient reported outcome of Treatment Satisfaction Questionnaire for Medication (TSQM-9) survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes for the effects of MS on the patient | patient reported outcome of The Effects of Your MS (PDDS) survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes for the presence of a MS relapse | patient reported outcome of My MS Relapse Evaluation survey | every 12 weeks for a period of 36 months |
| Clinic Outcomes reporting of MS patient daily symptoms | patient reported outcome of the Daily Symptoms survey | every 12 weeks for a period of 36 months |
| Medical History | data regarding medical history reported by the patient | every 12 weeks for a period of 36 months |
| Hospitalization | data regarding hospitalization reported by the patient | every 12 weeks for a period of 36 months |
| Demographic information | data regarding demographics reported by the patient | every 12 weeks for a period of 36 months |
| Medication | survey data regarding medication use reported by the patient | every 12 weeks for a period of 36 months |
| MRI utilization | survey data regarding number of MRIs reported by the patient | every 12 weeks for a period of 36 months |
| Exercise | survey data regarding daily exercise | collected daily and summarized annually. |
| System level measure the patient experience for ambulatory care. | Health care quality assessment collected through the Aggregated Clinician and Group Survey to assess patient experience in ambulatory care. | every 12 weeks for a period of 36 months |
| System level measure of Health Care Quality | Patient determined disease steps survey | every 12 weeks for a period of 36 months |
| Boston |
| Massachusetts |
| 02114 |
| United States |
| Concord Hospital | Concord | New Hampshire | 03301 | United States |
| University of Vermont Multiple Sclerosis Center | Burlington | Vermont | 05401 | United States |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |