Project title | Research question | Setting | Patient population | Design | Example of changes during planning period |
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Active Bathing to Eliminate Infection (ABATE Infection) | Does routine daily bathing with antiseptic soap for all patients plus targeted use of a nasal antibiotic ointment for MRSA carriers reduce multidrug resistant organisms and bloodstream infections in general medical, surgical, and oncology inpatient units? | Hospital Corporation of America (HCA) | Inpatients in non-critical care units at 53 U.S. HCA hospitals. Units where chlorhexidine bathing or nasal decolonization is common were excluded. | Cluster randomized trial of hospitals to compare two quality improvement strategies to reduce multidrug resistant organisms and bloodstream infections in non-critical care units. The two strategies to be evaluated are: | No changes of note. |
Arm 1: Routine Care - Routine policy for showering/bathing | |||||
Arm 2: Decolonization - Use of chlorhexidine as routine soap for showering or bed bathing for all patients plus mupirocin × 5 days if MRSA+ by history, culture, or screen | |||||
A Pragmatic Trial of Lumbar Image Reporting with Epidemiology (LIRE) | Does adding epidemiologic benchmark data to spine imaging reports decrease subsequent back-related healthcare utilization? | Primary care clinics within the Kaiser Permanente-Northern California, Group Health Cooperative, Mayo Clinic Health System, and Henry Ford Health System | Approximately 150,000 adults for whom a primary care provider has requested imaging of the lumbar spine | Cluster randomized trial comparing typical imaging reports to those that include benchmarks prevalence data of findings in patients without back pain. | Clinics with a single provider were excluded, making recruitment slightly more restricted. |
Collaborative Care for Chronic Pain in Primary Care (PPACT) | Does an interdisciplinary team-based program sited in primary care help patients manage chronic pain? | Primary practices in three Kaiser Permanente regions | Approximately 1,000 patients prioritized by their providers who have nonmalignant chronic pain and who are on long-term opioid therapy. | Mixed-methods cluster-randomized trial comparing multispecialty services within the primary care setting to usual care. The intervention is an integrated, interdisciplinary program that guides all pain-related care for intervention patients. It is embedded into everyday clinical practice flow utilizing assessment measures and intervention staff directly from the clinical care system. | Study infrastructure built to support and bolster EMR-based patient reported outcome data collection. |
Strategies and Opportunities to Stop Colon Cancer in Priority Populations (STOP CRC) | Does an evidence-based, culturally tailored approach increase colorectal cancer screening in clinics that serve minority and low-income populations? | Federally Qualified Health Center clinics | 30,000 patients aged 50 to 74 with no evidence of having had a recent colorectal cancer screening exam (fecal test, sigmoidoscopy or colonoscopy), and no history of colorectal disease. | Cluster randomized trial comparing usual care to intervention. The intervention consists of an automated data-driven, electronic health record-linked program for mailing FIT kits (with linguistically appropriate pictographic instructions and return postage) to patients due for CRC screening. | STOP CRC allowed patient reminders to be sent by email or letter and used a standard, well-validated quality improvement process (Plan-Do-Study-Act cycles) to facilitate program adaptations. |
Time to Reduce Mortality in End-Stage Renal Disease (TiME) | Does systematically implementing a hemodialysis session duration of at least 4.25 hours improve survival, reduce hospitalizations and improve quality of life for patients with end-stage kidney disease? | Two large dialysis provider organizations | 6432 patients with end stage renal disease treated by thrice weekly maintenance hemodialysis | Cluster-randomized, parallel-group clinical trial for patients initiating treatment with maintenance hemodialysis. Facilities are randomized in a 1:1 distribution to either: Intervention arm: recommend dialysis session durations of at least 4.25 hours for all patients initiating hemodialysis treatment regardless of body size or dialysis solute clearance measurements, or Usual care arm: no trial-driven approach to session duration. | 24 hour urine collection eliminated and the quality of life survey was changed to the survey administered as part of routine care. |