Rapid cycle, randomised testing of precision feedback to improve engagement with a process measure dashboard amongst urologists: study protocol for a hybrid trial
Introduction Rapid-cycle randomised testing holds high potential to enhance quality improvement practice but remains under-utilised because it requires significant resource commitment. However, infrastructure for learning networks, such as collaborative quality initiatives and large-scale quality im...
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/5/e092742.full |
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| author | Zach Landis-Lewis Stephanie Daignault-Newton Khurshid R Ghani Patrick Lewicki Bassel Salka Jerison Ross Andrew Krumm Casey Dauw Kristian D Stensland |
| author_facet | Zach Landis-Lewis Stephanie Daignault-Newton Khurshid R Ghani Patrick Lewicki Bassel Salka Jerison Ross Andrew Krumm Casey Dauw Kristian D Stensland |
| author_sort | Zach Landis-Lewis |
| collection | DOAJ |
| description | Introduction Rapid-cycle randomised testing holds high potential to enhance quality improvement practice but remains under-utilised because it requires significant resource commitment. However, infrastructure for learning networks, such as collaborative quality initiatives and large-scale quality improvement consortia, holds potential to support rapid-cycle testing at low cost and with minimal effort. For example, rapid-cycle randomised testing could be used to optimise ‘precision feedback’, which prioritises highly motivating tailored content to improve engagement with audit and feedback. We combined these concepts (rapid cycle, randomised testing and precision feedback) with a low-resource emphasis in conceiving this trial.Methods and analysis A stepped wedge randomised controlled trial will deliver an intervention consisting of precision feedback and modifications to audit and feedback communication to 100 urologists performing ureteroscopy within the Michigan Urological Surgery Improvement Collaborative (MUSIC) and will be compared with a control consisting of standard ‘one-size-fits-all’ audit and feedback. The study’s primary endpoint is online dashboard engagement, measured as the clickthrough rate through the tracking of embedded links in emails. The stent rate following pre-stented ureteroscopy will also be measured. The primary hypothesis is that precision feedback will increase engagement with an audit and feedback dashboard and decrease rates of stenting following pre-stented ureteroscopy. Endpoints will be analysed by linear modelling accounting for repeated measures within individuals, exploring the primary hypothesis through a main effect by the study arm.Ethics and dissemination Ethics and regulatory approval have been obtained from the Institutional Review Board of the University of Michigan (HUM#00248876). The findings will be disseminated in peer-reviewed journals and conferences.Trial registration number ClinicalTrials.gov registration number: NCT06465667. Registered 6/20/2024. <https://clinicaltrials.gov/study/NCT06465667> |
| format | Article |
| id | doaj-art-b6d27602567f4cfbae5474489df2da7b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b6d27602567f4cfbae5474489df2da7b2025-08-20T03:53:17ZengBMJ Publishing GroupBMJ Open2044-60552025-05-0115510.1136/bmjopen-2024-092742Rapid cycle, randomised testing of precision feedback to improve engagement with a process measure dashboard amongst urologists: study protocol for a hybrid trialZach Landis-Lewis0Stephanie Daignault-Newton1Khurshid R Ghani2Patrick Lewicki3Bassel Salka4Jerison Ross5Andrew Krumm6Casey Dauw7Kristian D Stensland8Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, USADepartment of Urology, University of Michigan, Ann Arbor, Michigan, USADepartment of Urology, University of Michigan, Ann Arbor, Michigan, USADepartment of Urology, University of Michigan, Ann Arbor, Michigan, USADepartment of Urology, University of Michigan, Ann Arbor, Michigan, USADepartment of Urology, University of Michigan, Ann Arbor, Michigan, USADepartment of Urology, University of Michigan, Ann Arbor, Michigan, USADepartment of Urology, University of Michigan, Ann Arbor, Michigan, USADepartment of Urology, University of Michigan, Ann Arbor, Michigan, USAIntroduction Rapid-cycle randomised testing holds high potential to enhance quality improvement practice but remains under-utilised because it requires significant resource commitment. However, infrastructure for learning networks, such as collaborative quality initiatives and large-scale quality improvement consortia, holds potential to support rapid-cycle testing at low cost and with minimal effort. For example, rapid-cycle randomised testing could be used to optimise ‘precision feedback’, which prioritises highly motivating tailored content to improve engagement with audit and feedback. We combined these concepts (rapid cycle, randomised testing and precision feedback) with a low-resource emphasis in conceiving this trial.Methods and analysis A stepped wedge randomised controlled trial will deliver an intervention consisting of precision feedback and modifications to audit and feedback communication to 100 urologists performing ureteroscopy within the Michigan Urological Surgery Improvement Collaborative (MUSIC) and will be compared with a control consisting of standard ‘one-size-fits-all’ audit and feedback. The study’s primary endpoint is online dashboard engagement, measured as the clickthrough rate through the tracking of embedded links in emails. The stent rate following pre-stented ureteroscopy will also be measured. The primary hypothesis is that precision feedback will increase engagement with an audit and feedback dashboard and decrease rates of stenting following pre-stented ureteroscopy. Endpoints will be analysed by linear modelling accounting for repeated measures within individuals, exploring the primary hypothesis through a main effect by the study arm.Ethics and dissemination Ethics and regulatory approval have been obtained from the Institutional Review Board of the University of Michigan (HUM#00248876). The findings will be disseminated in peer-reviewed journals and conferences.Trial registration number ClinicalTrials.gov registration number: NCT06465667. Registered 6/20/2024. <https://clinicaltrials.gov/study/NCT06465667>https://bmjopen.bmj.com/content/15/5/e092742.full |
| spellingShingle | Zach Landis-Lewis Stephanie Daignault-Newton Khurshid R Ghani Patrick Lewicki Bassel Salka Jerison Ross Andrew Krumm Casey Dauw Kristian D Stensland Rapid cycle, randomised testing of precision feedback to improve engagement with a process measure dashboard amongst urologists: study protocol for a hybrid trial BMJ Open |
| title | Rapid cycle, randomised testing of precision feedback to improve engagement with a process measure dashboard amongst urologists: study protocol for a hybrid trial |
| title_full | Rapid cycle, randomised testing of precision feedback to improve engagement with a process measure dashboard amongst urologists: study protocol for a hybrid trial |
| title_fullStr | Rapid cycle, randomised testing of precision feedback to improve engagement with a process measure dashboard amongst urologists: study protocol for a hybrid trial |
| title_full_unstemmed | Rapid cycle, randomised testing of precision feedback to improve engagement with a process measure dashboard amongst urologists: study protocol for a hybrid trial |
| title_short | Rapid cycle, randomised testing of precision feedback to improve engagement with a process measure dashboard amongst urologists: study protocol for a hybrid trial |
| title_sort | rapid cycle randomised testing of precision feedback to improve engagement with a process measure dashboard amongst urologists study protocol for a hybrid trial |
| url | https://bmjopen.bmj.com/content/15/5/e092742.full |
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