Performance feedback on the quality of care in hospitals performing thrombectomy for ischemic stroke (PERFEQTOS): protocol of a stepped wedge cluster randomized trial

Marzyeh Amini; Sanne J. den Hartog; on behalf of the PERFEQTOS Investigators; Nikki van Leeuwen; Frank Eijkenaar; Laurien S. Kuhrij; Lotte J. Stolze; Paul J. Nederkoorn; Hester F. Lingsma; Adriaan C.G.M. van Es; Ido R. van den Wijngaard; Aad van der Lugt; Diederik W.J. Dippel; Bob Roozenbeek

doi:10.1186/s13063-021-05819-z

Performance feedback on the quality of care in hospitals performing thrombectomy for ischemic stroke (PERFEQTOS): protocol of a stepped wedge cluster randomized trial

Marzyeh Amini, Sanne J. den Hartog, on behalf of the PERFEQTOS Investigators, Nikki van Leeuwen, Frank Eijkenaar, Laurien S. Kuhrij, Lotte J. Stolze, Paul J. Nederkoorn, Hester F. Lingsma, Adriaan C.G.M. van Es, Ido R. van den Wijngaard, Aad van der Lugt, Diederik W.J. Dippel, Bob Roozenbeek^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Although the provision of performance feedback to healthcare professionals based on data from quality registries is common practice in many fields of medicine, observational studies of its effect on the quality of care have shown mixed results. The objective of this study is to evaluate the effect of performance feedback on the quality of care for acute ischemic stroke. Methods: PERFEQTOS is a stepped wedge cluster randomized trial in 13 hospitals in the Netherlands providing endovascular thrombectomy for ischemic stroke. The primary outcome is the hospital’s door-to-groin time. The study starts with a 6-month period in which none of the hospitals receives the performance feedback intervention. Subsequently, every 6 months, three or four hospitals are randomized to cross over from the control to the intervention conditions, until all hospitals receive the feedback intervention. The feedback intervention consists of a dashboard with quarterly reports on patient characteristics, structure, process, and outcome indicators related to patients with ischemic stroke treated with endovascular thrombectomy. Hospitals can compare their present performance with their own performance in the past and with other hospitals. The performance feedback is provided to local quality improvement teams in each hospital, who define their own targets on specific indicators and develop performance improvement plans. The impact of the performance feedback and improvement plans will be evaluated by comparing the primary outcome before and after the intervention. Discussion: This study will provide evidence on the effectiveness of performance feedback to healthcare providers. The results will be actively disseminated through peer-reviewed journals, conference presentations, and various stakeholder engagement activities. Trial registration: Netherlands Trial Register NL9090. Registered on December 3, 2020.

Original language	English
Article number	870
Journal	Trials
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s13063-021-05819-z
Publication status	Published - 4 Dec 2021

Bibliographical note

Funding Information:
This work is supported by a grant from the Erasmus University Rotterdam, The Netherlands (Erasmus Initiative “Smarter Choices for Better Health,” Action Line “Value-Based Health Care”). Award/Grant number: not applicable.

Funding Information:
This study protocol was published on behalf of the PERFEQTOS Investigators: Bob Roozenbeek; Sanne J. den Hartog; Diederik W.J. Dippel; Aad van der Lugt; Hester F. Lingsma; Nikki van Leeuwen; Laurien S. Kuhrij, Lotte J. Stolze; Paul J. Nederkoorn; Adriaan C.G.M. van Es; Ido R. van den Wijngaard; Paula M. Janssen; Pieter-Jan van Doormaal; Yvo B.W.E.M. Roos; Bart J. Emmer; Suzanne M. Silvis; Wouter Dinkelaar; Michel J.M. Remmers; Douwe L.D. Vos; Rob A.R. Gons; Lonneke S.F. Yo; Julia H. van Tuijl; Hans Kortman; Jelis Boiten, Geert J. Lycklama ? Nijeholt; Jurgen R. Piet; Wouter Stomp; Heleen M. den Hertog; H. Zwenneke Flach; Nyika D. Kruyt; Marianne A.A. van Walderveen; Wim H. van Zwam; Robert J. van Oostenbrugge; Jasper M. Martens, Jeannette Hofmeijer; H. Bart van der Worp; Rob T.H. Lo. Trial sponsor: Erasmus MC, University Medical Center Rotterdam Contact name: Bob Roozenbeek Address: Department of Neurology Erasmus MC, University Medical Center Rotterdam Dr. Molewaterplein 40 3015 GD Rotterdam, the Netherlands Email: b.roozenbeek@erasmusmc.nl

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© 2021, The Author(s).

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Amini, M., den Hartog, S. J., on behalf of the PERFEQTOS Investigators, van Leeuwen, N., Eijkenaar, F., Kuhrij, L. S., Stolze, L. J., Nederkoorn, P. J., Lingsma, H. F., van Es, A. C. G. M., van den Wijngaard, I. R., van der Lugt, A., Dippel, D. W. J., & Roozenbeek, B. (2021). Performance feedback on the quality of care in hospitals performing thrombectomy for ischemic stroke (PERFEQTOS): protocol of a stepped wedge cluster randomized trial. Trials, 22(1), [870]. https://doi.org/10.1186/s13063-021-05819-z

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title = "Performance feedback on the quality of care in hospitals performing thrombectomy for ischemic stroke (PERFEQTOS): protocol of a stepped wedge cluster randomized trial",

abstract = "Background: Although the provision of performance feedback to healthcare professionals based on data from quality registries is common practice in many fields of medicine, observational studies of its effect on the quality of care have shown mixed results. The objective of this study is to evaluate the effect of performance feedback on the quality of care for acute ischemic stroke. Methods: PERFEQTOS is a stepped wedge cluster randomized trial in 13 hospitals in the Netherlands providing endovascular thrombectomy for ischemic stroke. The primary outcome is the hospital{\textquoteright}s door-to-groin time. The study starts with a 6-month period in which none of the hospitals receives the performance feedback intervention. Subsequently, every 6 months, three or four hospitals are randomized to cross over from the control to the intervention conditions, until all hospitals receive the feedback intervention. The feedback intervention consists of a dashboard with quarterly reports on patient characteristics, structure, process, and outcome indicators related to patients with ischemic stroke treated with endovascular thrombectomy. Hospitals can compare their present performance with their own performance in the past and with other hospitals. The performance feedback is provided to local quality improvement teams in each hospital, who define their own targets on specific indicators and develop performance improvement plans. The impact of the performance feedback and improvement plans will be evaluated by comparing the primary outcome before and after the intervention. Discussion: This study will provide evidence on the effectiveness of performance feedback to healthcare providers. The results will be actively disseminated through peer-reviewed journals, conference presentations, and various stakeholder engagement activities. Trial registration: Netherlands Trial Register NL9090. Registered on December 3, 2020.",

author = "Marzyeh Amini and {den Hartog}, {Sanne J.} and {on behalf of the PERFEQTOS Investigators} and {van Leeuwen}, Nikki and Frank Eijkenaar and Kuhrij, {Laurien S.} and Stolze, {Lotte J.} and Nederkoorn, {Paul J.} and Lingsma, {Hester F.} and {van Es}, {Adriaan C.G.M.} and {van den Wijngaard}, {Ido R.} and {van der Lugt}, Aad and Dippel, {Diederik W.J.} and Bob Roozenbeek and Roos, {Yvo B.W.E.M.} and Emmer, {Bart J.} and Silvis, {Suzanne M.} and Wouter Dinkelaar and Remmers, {Michel J.M.} and Vos, {Douwe L.D.} and Gons, {Rob A.R.} and Yo, {Lonneke S.F.} and {van Tuijl}, {Julia H.} and Hans Kortman and Jelis Boiten and {Lycklama {\`a} Nijeholt}, {Geert J.} and Piet, {Jurgen R.} and Wouter Stomp and {den Hertog}, {Heleen M.} and Flach, {H. Zwenneke} and Kruyt, {Nyika D.} and {van Walderveen}, {Marianne A.A.} and {van Zwam}, {Wim H.} and {van Oostenbrugge}, {Robert J.} and Martens, {Jasper M.} and Jeannette Hofmeijer and {van der Worp}, {H. Bart} and Lo, {Rob T.H.}",

note = "Funding Information: This work is supported by a grant from the Erasmus University Rotterdam, The Netherlands (Erasmus Initiative “Smarter Choices for Better Health,” Action Line “Value-Based Health Care”). Award/Grant number: not applicable. Funding Information: This study protocol was published on behalf of the PERFEQTOS Investigators: Bob Roozenbeek; Sanne J. den Hartog; Diederik W.J. Dippel; Aad van der Lugt; Hester F. Lingsma; Nikki van Leeuwen; Laurien S. Kuhrij, Lotte J. Stolze; Paul J. Nederkoorn; Adriaan C.G.M. van Es; Ido R. van den Wijngaard; Paula M. Janssen; Pieter-Jan van Doormaal; Yvo B.W.E.M. Roos; Bart J. Emmer; Suzanne M. Silvis; Wouter Dinkelaar; Michel J.M. Remmers; Douwe L.D. Vos; Rob A.R. Gons; Lonneke S.F. Yo; Julia H. van Tuijl; Hans Kortman; Jelis Boiten, Geert J. Lycklama ? Nijeholt; Jurgen R. Piet; Wouter Stomp; Heleen M. den Hertog; H. Zwenneke Flach; Nyika D. Kruyt; Marianne A.A. van Walderveen; Wim H. van Zwam; Robert J. van Oostenbrugge; Jasper M. Martens, Jeannette Hofmeijer; H. Bart van der Worp; Rob T.H. Lo. Trial sponsor: Erasmus MC, University Medical Center Rotterdam Contact name: Bob Roozenbeek Address: Department of Neurology Erasmus MC, University Medical Center Rotterdam Dr. Molewaterplein 40 3015 GD Rotterdam, the Netherlands Email: b.roozenbeek@erasmusmc.nl Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

day = "4",

doi = "10.1186/s13063-021-05819-z",

language = "English",

volume = "22",

journal = "Trials",

issn = "1745-6215",

publisher = "BioMed Central Ltd.",

number = "1",

}

Amini, M, den Hartog, SJ, on behalf of the PERFEQTOS Investigators, van Leeuwen, N , Eijkenaar, F, Kuhrij, LS, Stolze, LJ, Nederkoorn, PJ, Lingsma, HF, van Es, ACGM, van den Wijngaard, IR, van der Lugt, A , Dippel, DWJ & Roozenbeek, B 2021, 'Performance feedback on the quality of care in hospitals performing thrombectomy for ischemic stroke (PERFEQTOS): protocol of a stepped wedge cluster randomized trial', Trials, vol. 22, no. 1, 870. https://doi.org/10.1186/s13063-021-05819-z

Performance feedback on the quality of care in hospitals performing thrombectomy for ischemic stroke (PERFEQTOS): protocol of a stepped wedge cluster randomized trial. / Amini, Marzyeh; den Hartog, Sanne J.; on behalf of the PERFEQTOS Investigators et al.
In: Trials, Vol. 22, No. 1, 870, 04.12.2021.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Performance feedback on the quality of care in hospitals performing thrombectomy for ischemic stroke (PERFEQTOS)

T2 - protocol of a stepped wedge cluster randomized trial

AU - Amini, Marzyeh

AU - den Hartog, Sanne J.

AU - on behalf of the PERFEQTOS Investigators

AU - van Leeuwen, Nikki

AU - Eijkenaar, Frank

AU - Kuhrij, Laurien S.

AU - Stolze, Lotte J.

AU - Nederkoorn, Paul J.

AU - Lingsma, Hester F.

AU - van Es, Adriaan C.G.M.

AU - van den Wijngaard, Ido R.

AU - van der Lugt, Aad

AU - Dippel, Diederik W.J.

AU - Roozenbeek, Bob

AU - Roos, Yvo B.W.E.M.

AU - Emmer, Bart J.

AU - Silvis, Suzanne M.

AU - Dinkelaar, Wouter

AU - Remmers, Michel J.M.

AU - Vos, Douwe L.D.

AU - Gons, Rob A.R.

AU - Yo, Lonneke S.F.

AU - van Tuijl, Julia H.

AU - Kortman, Hans

AU - Boiten, Jelis

AU - Lycklama à Nijeholt, Geert J.

AU - Piet, Jurgen R.

AU - Stomp, Wouter

AU - den Hertog, Heleen M.

AU - Flach, H. Zwenneke

AU - Kruyt, Nyika D.

AU - van Walderveen, Marianne A.A.

AU - van Zwam, Wim H.

AU - van Oostenbrugge, Robert J.

AU - Martens, Jasper M.

AU - Hofmeijer, Jeannette

AU - van der Worp, H. Bart

AU - Lo, Rob T.H.

N1 - Funding Information: This work is supported by a grant from the Erasmus University Rotterdam, The Netherlands (Erasmus Initiative “Smarter Choices for Better Health,” Action Line “Value-Based Health Care”). Award/Grant number: not applicable. Funding Information: This study protocol was published on behalf of the PERFEQTOS Investigators: Bob Roozenbeek; Sanne J. den Hartog; Diederik W.J. Dippel; Aad van der Lugt; Hester F. Lingsma; Nikki van Leeuwen; Laurien S. Kuhrij, Lotte J. Stolze; Paul J. Nederkoorn; Adriaan C.G.M. van Es; Ido R. van den Wijngaard; Paula M. Janssen; Pieter-Jan van Doormaal; Yvo B.W.E.M. Roos; Bart J. Emmer; Suzanne M. Silvis; Wouter Dinkelaar; Michel J.M. Remmers; Douwe L.D. Vos; Rob A.R. Gons; Lonneke S.F. Yo; Julia H. van Tuijl; Hans Kortman; Jelis Boiten, Geert J. Lycklama ? Nijeholt; Jurgen R. Piet; Wouter Stomp; Heleen M. den Hertog; H. Zwenneke Flach; Nyika D. Kruyt; Marianne A.A. van Walderveen; Wim H. van Zwam; Robert J. van Oostenbrugge; Jasper M. Martens, Jeannette Hofmeijer; H. Bart van der Worp; Rob T.H. Lo. Trial sponsor: Erasmus MC, University Medical Center Rotterdam Contact name: Bob Roozenbeek Address: Department of Neurology Erasmus MC, University Medical Center Rotterdam Dr. Molewaterplein 40 3015 GD Rotterdam, the Netherlands Email: b.roozenbeek@erasmusmc.nl Publisher Copyright: © 2021, The Author(s).

PY - 2021/12/4

Y1 - 2021/12/4

N2 - Background: Although the provision of performance feedback to healthcare professionals based on data from quality registries is common practice in many fields of medicine, observational studies of its effect on the quality of care have shown mixed results. The objective of this study is to evaluate the effect of performance feedback on the quality of care for acute ischemic stroke. Methods: PERFEQTOS is a stepped wedge cluster randomized trial in 13 hospitals in the Netherlands providing endovascular thrombectomy for ischemic stroke. The primary outcome is the hospital’s door-to-groin time. The study starts with a 6-month period in which none of the hospitals receives the performance feedback intervention. Subsequently, every 6 months, three or four hospitals are randomized to cross over from the control to the intervention conditions, until all hospitals receive the feedback intervention. The feedback intervention consists of a dashboard with quarterly reports on patient characteristics, structure, process, and outcome indicators related to patients with ischemic stroke treated with endovascular thrombectomy. Hospitals can compare their present performance with their own performance in the past and with other hospitals. The performance feedback is provided to local quality improvement teams in each hospital, who define their own targets on specific indicators and develop performance improvement plans. The impact of the performance feedback and improvement plans will be evaluated by comparing the primary outcome before and after the intervention. Discussion: This study will provide evidence on the effectiveness of performance feedback to healthcare providers. The results will be actively disseminated through peer-reviewed journals, conference presentations, and various stakeholder engagement activities. Trial registration: Netherlands Trial Register NL9090. Registered on December 3, 2020.

AB - Background: Although the provision of performance feedback to healthcare professionals based on data from quality registries is common practice in many fields of medicine, observational studies of its effect on the quality of care have shown mixed results. The objective of this study is to evaluate the effect of performance feedback on the quality of care for acute ischemic stroke. Methods: PERFEQTOS is a stepped wedge cluster randomized trial in 13 hospitals in the Netherlands providing endovascular thrombectomy for ischemic stroke. The primary outcome is the hospital’s door-to-groin time. The study starts with a 6-month period in which none of the hospitals receives the performance feedback intervention. Subsequently, every 6 months, three or four hospitals are randomized to cross over from the control to the intervention conditions, until all hospitals receive the feedback intervention. The feedback intervention consists of a dashboard with quarterly reports on patient characteristics, structure, process, and outcome indicators related to patients with ischemic stroke treated with endovascular thrombectomy. Hospitals can compare their present performance with their own performance in the past and with other hospitals. The performance feedback is provided to local quality improvement teams in each hospital, who define their own targets on specific indicators and develop performance improvement plans. The impact of the performance feedback and improvement plans will be evaluated by comparing the primary outcome before and after the intervention. Discussion: This study will provide evidence on the effectiveness of performance feedback to healthcare providers. The results will be actively disseminated through peer-reviewed journals, conference presentations, and various stakeholder engagement activities. Trial registration: Netherlands Trial Register NL9090. Registered on December 3, 2020.

UR - http://www.scopus.com/inward/record.url?scp=85120856443&partnerID=8YFLogxK

U2 - 10.1186/s13063-021-05819-z

DO - 10.1186/s13063-021-05819-z

M3 - Article

AN - SCOPUS:85120856443

SN - 1745-6215

VL - 22

JO - Trials

JF - Trials

IS - 1

M1 - 870

ER -

Performance feedback on the quality of care in hospitals performing thrombectomy for ischemic stroke (PERFEQTOS): protocol of a stepped wedge cluster randomized trial

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