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).
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
100
The Dashboard intervention, representing current standard of care, will consist of a standard e-mail message with a link to the dashboard and text explanation. No performance data will be included in the e-mail, and links will not be monitored for clickthrough with repeat e-mail.
The experimental intervention, precision feedback e-mail messaging, will consist of an e-mail with a link to the dashboard along with tailored information about a participant's performance in the quality process measure of interest. For example, e-mail subject lines may read "You have room for improvement in stent omission," accompanied by a visual display in the body of the e-mail showing a participant's performance relative to a top performing peer. The behavior change intervention delivery component will also involve modifications to existing procedures. Namely, performance feedback will be reported directly in the e-mail as either plain text, or an embedded or attached image with graphed data.
University of Michigan
Ann Arbor, Michigan, United States
Clickthrough rate to the online dashboard
Clickthrough is defined as a link ever being clicked in the three months following e-mail send date, at which point in time a new e-mail will be sent. Clickthrough rate will be calculated as the number of clickthroughs divided by number of links sent (i.e., opportunities for clickthrough).
Time frame: Every 3 months up to 15 months
Total number of dashboard visits
Dashboard visits captured by Google Analytics.
Time frame: 15 months
Cumulative time (minutes) spent on the dashboard
Time spent will be captured by Google Analytics.
Time frame: 15 months
Urologist opt-out rate
Time frame: 15 months
Helpful/not helpful rate
There will be one question if the intervention was helpful or not.
Time frame: 15 months
Stent rate for pre-stented ureteroscopy
Time frame: 15 months
E-mail open rate
E-mail open rate will be measured as number of e-mail opens divided by number of e-mails sent.
Time frame: Every 3 months up to 15 months
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