Using Electronically Derived Automated Reports of Appropriate Antibiotic Use to Inform Stewardship Interventions (EMPOWER)
Community-acquired Pneumonia, Acute Otitis Media, Pharyngitis
About this trial
This is an interventional other trial for Community-acquired Pneumonia focused on measuring Antibiotic stewardship, Implementation Science, Antibiotic Use, Outpatient antibiotic prescribing, Inpatient antibiotic prescribing
Eligibility Criteria
Patient Inclusion Criteria: Diagnosis of one of four conditions based on ICD-10 diagnostic codes. Patient Exclusion Criteria: Presence of specific complex chronic conditions Use of immunocompromising medications Transfer from another health facility. Clinician Inclusion Criteria: Prescribing clinicians (including attending physicians, fellows, residents, nurse practitioners, and physician assistants) at one of the participating outpatient practices or inpatient units. Age ≥ 18 years old Employed by one of the participating sites Clinician Exclusion Criteria: Volunteers or other non-employee hospital staff Limited English proficiency
Sites / Locations
- Children's Hospital of PhiladelphiaRecruiting
- University of Pennsylvania Health SystemRecruiting
Arms of the Study
Arm 1
Arm 2
Other
No Intervention
Prescribing Clinicians
Patients diagnosed with conditions of interest during study period
During the pre-intervention period which will last up to approximately 24 months, investigators will retrospectively collect data on appropriate antibiotic prescribing for the conditions. In the post-intervention period of approximately 24 months, investigators will implement a provider-focused intervention, consisting of feedback reports to providers using the validated metrics of antibiotic prescribing. These measures are based on national guidelines for appropriate antibiotic prescribing. Following implementation of the intervention, the investigative team will collect the same measures.
Interactions between investigators and patients will be limited to review of existing EHR data. Investigators will have no direct contact with patients. The data from the University of Pennsylvania Health System (UPHS) and Children's Hospital of Philadelphia (CHOP) will be extracted from data warehouses that store data from the electronic health record. These data will be used in feedback report generation as well as in outcome assessment. An estimated total of 10,000 inpatients with CAP (adult and pediatric) will be recruited. Similarly, about 500,000 patients (adult pharyngitis and pediatric acute otitis media combined) will be recruited in the outpatient setting.