An interventional study of Enhanced feedback and Standard feedback in Pneumonia, sponsored by KEMRI-Wellcome Trust Collaborative Research Program. Completed at 12 sites in Kenya. Open to participants aged 2 Months to 59 Months. Per ClinicalTrials.gov, last updated 2017-07-24.
Sponsored by KEMRI-Wellcome Trust Collaborative Research Program · Not applicable, Interventional, and Health services research
A cluster randomised pragmatic trial will be conducted within an emerging clinical information network composed of 12 Kenyan county hospitals. Hospitals will be randomised to an enhanced feedback intervention delivered over a nine-month period and compared to standard feedback. The trial to be implemented during a phase of implementing change in guideline recommendations for pneumonia will assess the impact of enhanced feedback on hospital uptake of the revised pneumonia treatment recommendations.
The international guidelines for the classification and treatment of childhood pneumonia were revised recently and in Kenya the national guidelines changed in February 2016. We designed an enhanced feedback intervention aimed at improving uptake of the revised pneumonia treatment policy within a clinical network of 12 Kenyan county referral hospitals.
Hospitals were randomized to receive either enhanced feedback (n = 6 hospitals) or standard feedback (n = 6 hospitals) delivered over a six-month period following nationwide pneumonia treatment policy change. The primary outcome is the proportion of all pneumonia admissions (fulfilling criteria for treatment with oral amoxicillin) who are correctly classified and treated using new guideline recommendations. The proportion of treatment change from oral amoxicillin to alternative antibiotics for pneumonia (considered a proxy measure of treatment failure) will be reported as a secondary outcome.
Exclusion Criteria:
1. Monthly written feedback incorporating goal setting, and action planning delivered by a senior clinical coordinator for selected pneumonia indicators 2. Two-monthly written feedback on multiple quality of paediatric care indicators 3. Clinical network promoting clinical leadership linked to mentorship and peer to peer support 4. Improved use of health information on service delivery
Behavioral: Enhanced feedback
1. Two-monthly written feedback on multiple quality of paediatric care indicators 2. Clinical network promoting clinical leadership linked to mentorship and peer to peer support 3. Improved use of health information on service delivery
Behavioral: Standard feedback
Hospital level feedback delivered every month through paediatrician on the level of adherence to revised pneumonia treatment recommendations.
Hospital level feedback delivered every two months through paediatrician on the performance of multiple paediatric care indicators for managing severely ill children.
Pneumonia classification and treatment
The proportion of all pneumonia admissions (fulfilling criteria for treatment with oral amoxicillin) who are correctly classified and treated using new guideline recommendations
Time frame: 9 months
Antibiotic change
The proportion of treatment change from oral amoxicillin to alternative antibiotics for pneumonia (considered a proxy measure of treatment failure)
Time frame: 9 months
Plan to share: No
This study is completed, as verified in Jul 2017. You cannot join it, but the record below documents what was studied.
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KEMRI-Wellcome Trust Collaborative Research Program