医院行缺血性脑卒中取栓术护理质量绩效反馈（PERFEQTOS）：一项阶梯式楔形集群随机试验方案。
Performance feedback on the quality of care in hospitals performing thrombectomy for ischemic stroke (PERFEQTOS): protocol of a stepped wedge cluster randomized trial.
机构信息
Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
出版信息
Trials. 2021 Dec 4;22(1):870. doi: 10.1186/s13063-021-05819-z.
BACKGROUND
Although the provision of performance feedback to healthcare professionals based on data from quality registries is common practice in many fields of medicine, observational studies of its effect on the quality of care have shown mixed results. The objective of this study is to evaluate the effect of performance feedback on the quality of care for acute ischemic stroke.
METHODS
PERFEQTOS is a stepped wedge cluster randomized trial in 13 hospitals in the Netherlands providing endovascular thrombectomy for ischemic stroke. The primary outcome is the hospital's door-to-groin time. The study starts with a 6-month period in which none of the hospitals receives the performance feedback intervention. Subsequently, every 6 months, three or four hospitals are randomized to cross over from the control to the intervention conditions, until all hospitals receive the feedback intervention. The feedback intervention consists of a dashboard with quarterly reports on patient characteristics, structure, process, and outcome indicators related to patients with ischemic stroke treated with endovascular thrombectomy. Hospitals can compare their present performance with their own performance in the past and with other hospitals. The performance feedback is provided to local quality improvement teams in each hospital, who define their own targets on specific indicators and develop performance improvement plans. The impact of the performance feedback and improvement plans will be evaluated by comparing the primary outcome before and after the intervention.
DISCUSSION
This study will provide evidence on the effectiveness of performance feedback to healthcare providers. The results will be actively disseminated through peer-reviewed journals, conference presentations, and various stakeholder engagement activities.
TRIAL REGISTRATION
Netherlands Trial Register NL9090 . Registered on December 3, 2020.
背景
尽管基于质量登记数据向医疗保健专业人员提供绩效反馈在许多医学领域是常见做法，但观察性研究表明其对护理质量的影响结果不一。本研究旨在评估绩效反馈对急性缺血性脑卒中护理质量的影响。
方法
PERFEQTOS 是荷兰 13 家医院的一项阶梯式楔形集群随机试验，这些医院为缺血性脑卒中患者提供血管内血栓切除术。主要结局是医院的门到股时间。该研究首先进行了 6 个月的时间，在此期间，没有一家医院接受绩效反馈干预。随后，每 6 个月，三到四家医院随机交叉到对照到干预条件，直到所有医院都接受反馈干预。反馈干预包括一个仪表板，其中包含与接受血管内血栓切除术治疗的缺血性脑卒中患者相关的患者特征、结构、过程和结果指标的季度报告。医院可以将其当前绩效与过去的绩效以及其他医院的绩效进行比较。绩效反馈提供给每家医院的当地质量改进团队，团队为特定指标定义自己的目标，并制定绩效改进计划。将通过比较干预前后的主要结局来评估绩效反馈和改进计划的影响。
讨论
本研究将提供关于向医疗保健提供者提供绩效反馈的有效性的证据。研究结果将通过同行评议期刊、会议演讲和各种利益相关者参与活动积极传播。
试验注册
荷兰临床试验注册 NL9090。于 2020 年 12 月 3 日注册。
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