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| ID | Type | Description | Link |
|---|---|---|---|
| GRT-00003877 | Other Grant/Funding Number | Agency for Health Care Research and Quality |
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| Name | Class |
|---|---|
| Agency for Healthcare Research and Quality (AHRQ) | FED |
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This multi-center, cluster randomized study aimed at improving implementation of vancomycin reducing practices (VRP) in neonatal intensive care units (NICUs). Sites will be recruited and randomized to receive either external facilitation or no external facilitation to assess the effect on center-level fidelity to the core components of VRP implementation. Interventions available to both study arms are directed at hospital staff and includes identification of local champions, educational outreach, unit-level audit & feedback, and use of a clinical decision support tool.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sites receiving external facilitation | Experimental | Sites will receive guidance from an external facilitator to support uptake of the VRP. |
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| Sites not receiving external facilitation | No Intervention | Sites will not receive guidance from an external facilitator. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| External Facilitation | Behavioral | Designated external facilitators will conduct monthly meetings with local champions at each site. Designated facilitators will follow the developed facilitation guide, that includes content area to cover in each meeting, case scenarios as examples, and tips on how to communicate and support the internal facilitators. The goal is to enable problem-solving and support the local champion in implementing VRP with fidelity |
| Measure | Description | Time Frame |
|---|---|---|
| Fidelity of VRP use | Proportion of late onset sepsis (LOS) evaluations performed with high fidelity. High fidelity is defined when the evaluation follows all three core components of VRP use. | 2.5 years - From beginning of implementation phase to the end of the sustainment phase |
| Measure | Description | Time Frame |
|---|---|---|
| Appropriateness/acceptability | Response to questions about whether vancomycin reducing practices (VRP) was agreeable and/or a good fit for the unit measured using validated instruments comprising of 5-point Likert scales (Weiner et al). Participants are offered options ranging from completely disagree (1) to completely agree (5), with higher scores indicating a higher degree of acceptability or feasibility. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kayla Gilpin | Contact | 215-573-3976 | kayla.gilpin@pennmedicine.upenn.edu | |
| Morgan Gabbert | Contact | 267-233-3150 | gabbertm@chop.edu |
| Name | Affiliation | Role |
|---|---|---|
| Sagori Mukhopadhyay, MD, MMSc | Children's Hospital of Philadelphia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kaiser Permanente Modesto Medical Center | Recruiting | Modesto | California | 95356 | United States |
Participants here are the clinicians at the sites randomized to external facilitation. The investigators obtain survey (de-identified) and interview data from representative group of the clinicians. Since the investigators will be gathering richly detailed qualitative data that, even if de-identified of names or locations, can still be linked back to sites or individuals, the investigators will not share interview data for secondary analysis or use beyond the purposes of the proposal. The investigators will maintain de-identified (for both site and respondent identifiers) survey output that can be shared upon appropriate request to the principal investigator.
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Cluster randomized study of external facilitation as an implementation strategy
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| 2.5 years - From beginning of implementation phase to the end of the sustainment phase |
| Kaiser Permanente East Bay - Oakland Medical Center | Recruiting | Oakland | California | 94611 | United States |
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| Kaiser Permanente Roseville Medical Center | Recruiting | Roseville | California | 95661 | United States |
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| Kaiser Permanente San Francisco Medical Center | Recruiting | San Francisco | California | 94115 | United States |
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| Kaiser Permanente San Leandro Medical Center | Recruiting | San Leandro | California | 94577 | United States |
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| Kaiser Permanente Santa Clara Medical Center | Recruiting | Santa Clara | California | 95051 | United States |
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| Kaiser Permanente Walnut Creek Medical Center | Recruiting | Walnut Creek | California | 94596 | United States |
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| Medical Center of Princeton | Recruiting | Plainsboro | New Jersey | 08536 | United States |
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| Virtua Voorhees | Recruiting | Voorhees Township | New Jersey | 08043 | United States |
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| Lancaster General Hospital | Recruiting | Lancaster | Pennsylvania | 17602 | United States |
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| Hospital of the University of Pennsylvania | Recruiting | Philadelphia | Pennsylvania | 19104 | United States |
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| Pennsylvania Hospital | Recruiting | Philadelphia | Pennsylvania | 19107 | United States |
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| Chester County Hospital | Recruiting | West Chester | Pennsylvania | 19380 | United States |
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| ID | Term |
|---|---|
| D000071074 | Neonatal Sepsis |
| ID | Term |
|---|---|
| D018805 | Sepsis |
| D007239 | Infections |
| D007232 | Infant, Newborn, Diseases |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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