RecruitingNot ApplicableNCT05735314

A New Combination of Evidence-Based Interventions to Improve Primary Care Diagnostic Safety and Efficiency

A New Combination of Evidence-Based Interventions to Improve Primary Care Diagnostic Safety and Efficiency: a Stepped Wedge Cluster Randomized Control Trial (RCT)

Sponsor

The University of Texas Health Science Center, Houston

Enrollment

450 participants

Start Date

Jan 8, 2024

Study Type

INTERVENTIONAL

Conditions

Anemia Decreased Glomerular Filtration Rate

Summary

The purpose of this study is to measure the evidence-based intervention's (EBIs) impact on patient safety and efficiency, to assess the EBIs implementation by measuring acceptability, appropriateness, cost, fidelity, penetration, and sustainability and to identify the facilitators and barriers that influence the degree of implementation of these EBIs.

Eligibility

Min Age: 18 Years

Inclusion Criteria7

physicians, physicians assistants and advanced practice registered nurses in the 13 clinic locations of UTP are eligible if they care for patients at the time patient enrollment at their clinic begins
agree to participate.
hemoglobin result < 10.8 for females and < 12.5 for males with normal white cell count and platelet count (the prior hemoglobin results must have been in normal range, with a look-back period of two years)
an eGFR value < 60 (the prior eGFR results must have been in normal range, with a look-back range of two years)
the matching creatinine results must also be in normal range
not pregnant
speak English or Spanish.

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Interventions

OTHEREnhanced diagnostic team implementing three evidence-based interventions

we designed an enhanced team process entailing: 1) using automated abnormal test result detection and tracking; 2) expanding the primary care team to include CPs to guide the evaluation of anemia to identify underlying causes; and 3) using NNs to engage patients in the healthcare team and diagnostic process and increase patient activation.

OTHERUsual care

Usual care involves primary care physicians ordering additional tests and referrals to evaluate patients with new anemia and decreased glomerular filtration rate (GFR) .