Evidence map›Paper›PMID 34526139›Full record

ArticleImplementation science communications2021

Daily weekday audit and feedback to clinicians for an inpatient intervention in obstetrics: is there sustained impact over the weekend? A secondary analysis of a prospective cohort study.

Rebecca F Hamm, Lisa D Levine, Meghan Lane-Fall, Rinad Beidas

Open access · goldAbstract read
In one paragraph

Article in Implementation science communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 83% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Rebecca F HammMaternal and Child Health Research Center, Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA, 19104, USA. Rebecca.feldmanhamm@uphs.upenn.edu.ORCID http://orcid.org/0000-0002-2587-2054
Lisa D LevineMaternal and Child Health Research Center, Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA, 19104, USA.
Meghan Lane-FallDepartment of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Rinad BeidasPenn Implementation Science Center at the Leonard Davis Institute (PISCE@LDI), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
University of Pennsylvania · USChild Development Center · QA

Funding

REPRODUCTIVE EPIDEMIOLOGY TRAINING GRANTT32HD007440 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI BARNHART, KURT T · 1996 to 2020
$7.5M
A standardized labor induction protocol to reduce primary cesarean and racial disparities in labor outcomes: a prospective cohort studyK23HD102523 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI HAMM, REBECCA FELDMAN · 2020 to 2023
$680k
Eunice Kennedy Shriver National Institute of Child Health and Human Development T32-HD007440NICHD NIH HHS K23 HD102523
6 · The paper itself

Abstract

backgroundAudit and feedback as an implementation strategy leads to small, but potentially important improvements in practice. Yet, audit and feedback is time and personnel intensive. Many interventions designed for inpatient care are meant to be utilized by care teams all days of the week, including weekends when research staff are at a minimum. We aimed to determine if audit and feedback regarding use of an evidence-based inpatient obstetric intervention performed only on weekdays could have a sustained impact over the weekend.

methodsThis study was performed as a secondary analysis of a prospective cohort study examining the impact of implementation of a validated calculator that predicts the likelihood of cesarean delivery during labor induction. During the 1 year postimplementation period, Monday through Friday, a member of the study team contacted clinicians daily to provide verbal feedback. While the same clinician pool worked weekend shifts, audit and feedback did not occur on Saturdays or Sundays. The primary outcome was intervention use, defined as documentation of counseling around the cesarean risk calculator result, in the electronic health record. Intervention use was compared between those with (weekdays) and without (weekends) audit and feedback.

resultsOf the 822 women meeting eligibility criteria during the postimplementation period (July 1, 2018-June 30, 2019), 651 (79.2%) were admitted on weekdays when audit and feedback was occurring and 171 (20.8%) on weekends without audit and feedback. The use of the cesarean risk calculator was recorded in 676 of 822 (82.2%) of eligible patient charts. There was no significant difference in cesarean risk calculator use overall by days when audit and feedback occurred versus days without audit and feedback (weekday admissions 82.0% vs. weekend admissions 83.0%, aOR 0.90 95% CI [0.57-1.40], p = 0.76). There was no significant trend in the relationship between calculator use and weekday versus weekend admission by month across the study period (p = 0.21).

conclusionsDaily weekday audit and feedback for implementation of an evidence-based inpatient obstetric intervention had sustained impact over the weekends. This finding may have implications for both research staffing, as well as sustainability efforts. Further research should determine the lowest effective frequency of audit and feedback to produce implementation success.

Indexed as

Audit and feedbackDosageImplementation strategyIntervention useSustainability

Identifiers

PMID34526139
PMCPMC8442329
OpenAlexW3199853042

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.