A Brief Intervention to Improve Cost-effective Resource Use Among Medicine Housestaff

This study has been completed.
Sponsor:
Collaborator:
Partners Center of Expertise in Quality and Patient Safety
Information provided by:
Brigham and Women's Hospital
ClinicalTrials.gov Identifier:
NCT01303263
First received: February 23, 2011
Last updated: June 21, 2011
Last verified: February 2011
  Purpose

OBJECTIVE: To test a brief intervention designed to improve the cost-effectiveness of care provided by medicine housestaff for hospitalized patients.

HYPOTHESIS: A brief intervention in which medicine residents receive itemized bills for recent patients cared for by them, followed by a discussion on approaches to reducing unnecessary inpatient costs, can result in significant cost reductions without adversely affecting patient outcomes.


Condition Intervention
Graduate Medical Education
Cost-Effectiveness
Behavioral: Educational Intervention

Study Type: Interventional
Study Design: Allocation: Randomized
Official Title: A Brief Intervention to Improve Cost-effective Resource Use Among Medicine Housestaff

Further study details as provided by Brigham and Women's Hospital:

Primary Outcome Measures:
  • Total Cost [ Time Frame: 2 weeks following educational intervention ] [ Designated as safety issue: No ]
    Total hospital cost per admission for 2 weeks following the educational intervention.

  • Lab Cost [ Time Frame: 2 weeks following educational intervention ] [ Designated as safety issue: No ]
    Total lab cost per admission for 2 weeks following the educational intervention.

  • Pharmacy Cost [ Time Frame: 2 weeks following educational intervention ] [ Designated as safety issue: No ]
    Total pharmacy cost per admission for 2 weeks following the educational intervention.

  • Radiology Cost [ Time Frame: 2 weeks following educational intervention ] [ Designated as safety issue: No ]
    Total radiology cost per admission for 2 weeks following the educational intervention.


Secondary Outcome Measures:
  • length of stay [ Time Frame: 2 weeks after educational intervention ] [ Designated as safety issue: No ]
  • admission to an intensive care unit (ICU) [ Time Frame: 2 weeks after educational intervention ] [ Designated as safety issue: Yes ]
  • 30-day readmission [ Time Frame: within 30 days after end of study period ] [ Designated as safety issue: Yes ]
  • 30-day mortality [ Time Frame: within 30 days after end of study period ] [ Designated as safety issue: Yes ]

Enrollment: 96
Study Start Date: September 2009
Study Completion Date: February 2011
Primary Completion Date: December 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Intervention Group
Residents Randomized to Receive Educational Intervention
Behavioral: Educational Intervention
45-minute teaching session on healthcare costs, in which each resident reviewed an itemized hospital bill for a patient he/she had cared for, followed by an open-ended discussion about reducing unnecessary costs.
No Intervention: Control Group
Residents randomized not to receive a teaching intervention.

Detailed Description:

We designed a brief educational intervention with two primary objectives: 1) to increase awareness among residents about how their decisions impact the costs of inpatient medical care; and 2) to improve the cost-effectiveness of care provided by residents without adversely affecting patient outcomes. We hypothesized that a brief intervention in which residents receive bills for patients they recently cared for, followed by a discussion on approaches to reducing unnecessary inpatient costs, would reduce costs without adversely affecting patient outcomes.

  Eligibility

Genders Eligible for Study:   Both
Criteria

Inclusion Criteria:

  • Internal Medicine Residents on Inpatient Rotations at Brigham & Women's Hospital

Exclusion Criteria:

  • Having a team member who was in either the control group or intervention group in a prior round of this study.
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01303263

Locations
United States, Massachusetts
Brigham & Women's Hospital
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Brigham and Women's Hospital
Partners Center of Expertise in Quality and Patient Safety
Investigators
Principal Investigator: David Bates, MD Brigham and Women's Hospital
Study Director: Benjamin D Sommers, MD, PhD Brigham and Women's Hospital
  More Information

No publications provided

Responsible Party: David Bates, Brigham & Women's Hospital
ClinicalTrials.gov Identifier: NCT01303263     History of Changes
Other Study ID Numbers: 2009-P-001758/1; BWH
Study First Received: February 23, 2011
Last Updated: June 21, 2011
Health Authority: United States: Institutional Review Board

Keywords provided by Brigham and Women's Hospital:
efficiency
cost-awareness
hospitals
graduate medical education

ClinicalTrials.gov processed this record on July 26, 2014