Using segmented regression analysis of interrupted time series data to assess colonoscopy quality outcomes of a web-enha
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Using segmented regression analysis of interrupted time series data to assess colonoscopy quality outcomes of a webenhanced implementation toolkit to support evidence-based practices for bowel preparation: a study protocol Ramsey et al. Ramsey et al. Implementation Science (2015) 10:85 DOI 10.1186/s13012-015-0276-3
Ramsey et al. Implementation Science (2015) 10:85 DOI 10.1186/s13012-015-0276-3 Implementation Science
STUDY PROTOCOL
Open Access
Using segmented regression analysis of interrupted time series data to assess colonoscopy quality outcomes of a webenhanced implementation toolkit to support evidence-based practices for bowel preparation: a study protocol Alex T. Ramsey1*, Julia Maki2, Beth Prusaczyk1, Yan Yan2, Jean Wang2 and Rebecca Lobb2
Abstract Background: While there is convincing evidence on interventions to improve bowel preparation for patients, the evidence on how to implement these evidence-based practices (EBPs) in outpatient colonoscopy settings is less certain. The Strategies to Improve Colonoscopy (STIC) study compares the effect of two implementation strategies, physician education alone versus physician education plus an implementation toolkit for staff, on adoption of three EBPs (split-dosing of bowel preparation, low-literacy education, teach-back) to improve pre-procedure and intra-procedure quality measures. The implementation toolkit contains a staff education module, website containing tools to support staff in delivering EBPs, tailored patient education materials, and brief consultation with staff to determine how the EBPs can be integrated into the existing workflow. Given adaptations to the implementation plan and intentional flexibility in the delivery of the EBPs, we utilize a pragmatic study to balance external validity with demonstrating effectiveness of the implementation strategies. Methods/Design: Participants will include all outpatient colonoscopy physicians, staff, and patients from a convenience sample of six endoscopy settings. Aim #1 will explore the relative effect of two strategies to implement patient-level EBPs on adoption and clinical quality outcomes. We will assess the change in level and trends of clinical quality outcomes (i.e., adequacy of bowel preparation, adenoma detection) using segmented regression analysis of interrupted time series data with two groups (intervention and delayed start). Aim #2 will examine the influence of organizational readiness to change on EBP implementation. We use a PRECIS diagram to reflect the extent to which each indicator of the study was pragmatic versus explanatory, revealing a largely pragmatic study. (Continued on next page)
* Correspondence: [email protected] 1 Washington University Brown School of Social Work, 1 Brookings Dr., St. Louis, MO 63130, USA Full list of author information is available at the end of the article © 2015 Ramsey et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted u
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