Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Neurology, Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 2/9/2019 |
| Start Date: | June 1, 2016 |
| End Date: | September 30, 2020 |
Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) (QUE 15-280)
This program will seek to implement a quality improvement program to improve the care of
Veterans with TIA or minor stroke at 6 Veteran Health Administration Hospitals. The
investigators will evaluate the implementation and effectiveness of the quality improvement
program.
Veterans with TIA or minor stroke at 6 Veteran Health Administration Hospitals. The
investigators will evaluate the implementation and effectiveness of the quality improvement
program.
Aim 1. To develop a quality improvement program to improve the care of Veterans with TIA or
minor stroke that can be deployed nationwide. The program will include multiple components: a
reporting system that is based on validated electronic quality measures (eCQMs) that will
allow staff to monitor the time-sensitive processes of care and outcomes of their population
of Veterans with TIA or minor stroke; clinical protocols to improve the timeliness and
completeness of care; professional education materials; and clinical note templates for use
by nursing and pharmacy staff. Lessons learned at the individual sites engaged in the quality
improvement program will be shared across sites by use of a web-based platform and a virtual
collaborative. We will assess end user's assessment of the program and its core elements.
Aim 2. To evaluate the effectiveness of the Aim 1 QI intervention program for Veterans with
TIA or minor stroke against usual care. Teams at the 6 intervention sites will be given the
quality improvement program components. The primary effectiveness outcome is the proportion
of Veterans who received all of the guideline-concordant processes of care for which they are
eligible referred to as the "Without-Fail" care rate.
Aim 3. To evaluate the implementation of the QI intervention program across the 6
participating sites. The two primary implementation outcomes will be the number of
implementation activities completed during the one-year active implementation period and the
final level of team organization (defined as the Group Organization (GO Score)) for providing
and improving TIA care at the end of the 12-month active implementation period.
Secondary Aim To evaluate the sustainability of the program. Sustainability will be evaluated
over a one-year period that begins immediately after the one-year active implementation
period. We will compare the Without-Fail rate in the sustainability period to the
post-implementation period.
minor stroke that can be deployed nationwide. The program will include multiple components: a
reporting system that is based on validated electronic quality measures (eCQMs) that will
allow staff to monitor the time-sensitive processes of care and outcomes of their population
of Veterans with TIA or minor stroke; clinical protocols to improve the timeliness and
completeness of care; professional education materials; and clinical note templates for use
by nursing and pharmacy staff. Lessons learned at the individual sites engaged in the quality
improvement program will be shared across sites by use of a web-based platform and a virtual
collaborative. We will assess end user's assessment of the program and its core elements.
Aim 2. To evaluate the effectiveness of the Aim 1 QI intervention program for Veterans with
TIA or minor stroke against usual care. Teams at the 6 intervention sites will be given the
quality improvement program components. The primary effectiveness outcome is the proportion
of Veterans who received all of the guideline-concordant processes of care for which they are
eligible referred to as the "Without-Fail" care rate.
Aim 3. To evaluate the implementation of the QI intervention program across the 6
participating sites. The two primary implementation outcomes will be the number of
implementation activities completed during the one-year active implementation period and the
final level of team organization (defined as the Group Organization (GO Score)) for providing
and improving TIA care at the end of the 12-month active implementation period.
Secondary Aim To evaluate the sustainability of the program. Sustainability will be evaluated
over a one-year period that begins immediately after the one-year active implementation
period. We will compare the Without-Fail rate in the sustainability period to the
post-implementation period.
Inclusion Criteria:
- This program will seek VA hospitals that are self-designated as either a VHA Primary
Stroke Center or a Limited Hours Stroke Facility or Supporting Stroke Center.
- That have >25 stroke/TIA patients per year and are willing to participate in the
quality improvement program.
- Eligibility for staff interviews is based on involvement in the QI intervention and
willingness to participate.
Exclusion Criteria:
- Unwilling to participate
We found this trial at
1
site
Indianapolis, Indiana 46202
Principal Investigator: Dawn M. Bravata, MD
Phone: 317-988-2359
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