None listed
Conditions
Brief summary
The number of Australians living with diabetes is increasing and so is the cost of healthcare for these people. Many people living with diabetes are managed by Australian diabetes centres. These centres are members of the National Association of Diabetes Centres (NADC) and include a mixture of primary, secondary and tertiary care facilities. The clinical management provided by these Centres is evaluated by the Australian National Diabetes Audit (ANDA), an annual benchmarking activity where de-identified patient data for a range of process and clinical outcomes is collected, collated and compared for all participating sites. A previous qualitative study sought opinions from clinical staff regarding the acceptability and utility of the audit feedback currently provided. This study has informed redevelopment of the feedback provided to participating sites and development of the cointerventions in this trial.. Providing these enhanced feedback and community of practice interventions in a cluster randomised trial will allow us to evaluate the utility and acceptability of the feedback and cointerventions provided, and also the effect on selected clinical outcomes. We hypothesise that delivery of redesigned audit feedback and educational and peer support resources to diabetes centres will improve the utility and acceptability of the Australian National Diabetes Audit (ANDA) feedback to participating diabetes centres. We also hypothesise that the interventions will lead to improved clinical outcomes including mean HbA1c. This project will contribute to the body of knowledge about how to bring about practice change in diabetes centres in Australia. The outcomes of the study have the potential to improve the health outcomes of the many people with diabetes managed by participating diabetes centres.
Interventions
Intervention arm:
Participating staff from diabetes centres randomised to the intervention arm will receive a targeted theory-based intervention designed to address identified, modifiable barriers to implementing recommendations from audit feedback provided by ANDA, in addition to the standard audit feedback report. Design of the intervention is underpinned by a formal qualitative study to elicit current quality improvement practices and barriers to implementation of feedback. This qualitative s
Intervention arm: Participating staff from diabetes centres randomised to the intervention arm will receive a targeted theory-based intervention designed to address identified, modifiable barriers to implementing recommendations from audit feedback provided by ANDA, in addition to the standard audit feedback report. Design of the intervention is underpinned by a formal qualitative study to elicit current quality improvement practices and barriers to implementation of feedback. This qualitative study sought opinions from clinical staff regarding the acceptability and utility of the audit feedback currently provided, via semi-structured interviews. This study has informed redevelopment of the feedback provided to participating sites and development of the cointerventions in this trial The intervention involves a reformatted version of the site report currently provided, along with a PowerPoint template for site use. This will be delivered electronically to participants by the ANDA research team at one point in time. Cointerventions will include a Quality Improvement (QI) webinar, 'change champion' videos, instructional videos and peer led forums. These will all be delivered via the National Association for Diabetes Centres (NADC) website, prior to receiving the new feedback report and PowerPoint presentation and will remain accessible to the intervention group. Access to these resources will be password protected to prevent contamination of the control group. Centres participating in the intervention arm will be expected to complete a minimum of 3 activities from the educational and peer support resources, including: 1. Attendance at the QI webinar – this will be hosted initially in the evening, with a replay with live question and answer session during a lunch hour, to facilitate maximum uptake 2. Viewing of at least one ‘clinical change champion’ video 3. Participation in at least one peer led forum We anticipate that the interventions will be delivered during a six month period from August 2020 to January 2021. we anticipate that the webinar will be delivered in the first 4 weeks of the intervention period (to allow for the initial live presentation and subsequent replay) and that the remaining activities ('clinical change champion' video and peer forums) can be completed anytime in the first 3 months of the intervention period. Participants will continue to have access to these resources until follow-up data is collected in February of 2021. Patient data: The study will not recruit patient participants. Rather, patient data for pre-determined fields will be harnessed from existing routinely collected and de-identified (coded) data reported as part of ANDA annual audit. We are not collecting any additional data directly from patients.
Sponsors
Monash University School of Public Health and Preventive Medicine
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Diabetes centres: Diabetes centres registered with the National Association of Diabetes Centres will be eligible for inclusion in the trial if the following criteria are met: (i) at least one representative of the practice (the designated contact person for ANDA) provides written informed consent; (ii) the practice participates in ANDA in 2021 (irrespective of whether they have or have not participated in previous years). The designated ANDA contact person for each participating site are the participants in this study, as they receive and act on the feedback provided. They must be over 18 years old and employed by the relevant diabetes centres. As the diabetes centres have a range of clinical staff and administrative staff involved in ANDA, there are no other restrictions regarding these staff. We will harness deidentified existing ANDA data relating to type 1 or type 2 diabetes mellitus in people aged 18 years and over.
Exclusion criteria
There are no additional exclusion criteria related to diabetes centres. We will not harness ANDA data relating to people with Gestational Diabetes Mellitus (GDM), or diabetes of unknown type.
Outcome results
None listed