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Field
Trial End Date
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Before
March 31, 2023
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After
June 30, 2023
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Field
Last Published
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Before
March 28, 2022 07:17 AM
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After
June 19, 2022 09:21 AM
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Field
Intervention (Public)
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Before
The treatment for both surgeons and nurses will consist of three components. First, at the beginning of each OR shift (morning and afternoon), treated individuals who are scheduled to work the shift will receive a personally customized text message to their mobile phone. The message comprises a general nudge and procedure specific information. The nudge reads “Dear Dr./Nurse X, For the surgeries this morning we remind you to avoid unnecessarily opening disposable equipment”. The procedure-specific information is a list of the planned procedures for the shift and for each procedure a recommended threshold (quantity) of input use for three candidate inputs. The threshold is the median quantity of that input used in the procedure in the 24 months preceding the experiment and approved by the medical professionals on the research team. Second, treated individuals have access to a website that includes a table of thresholds for all candidate inputs. Staff can use this website to check thresholds for inputs that are not included in the message, or when changes in scheduled surgeries occur and no messages are sent. The access to the threshold website is regulated by e-mail and password with access granted only to treated staff. The final component of the treatment is a bi-weekly feedback email, sent to treated surgeons and nurses, containing information on the candidate inputs actually used during the surgeries they conducted over the last 14 days, compared to the recommended amounts.
For details on how we chose candidate inputs, please see the pre-analysis plan.
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After
The treatment for both surgeons and nurses consists of three components.
First, at the beginning of each OR shift, treated individuals who are scheduled to work the shift will receive a personally customized message to their mobile phone. The message comprises a general nudge as well as a set of input recommendations for each upcoming procedure. The nudge reads “Dear Dr./Nurse X, For the surgeries this morning we remind you to avoid unnecessarily opening disposable equipment”. Then, for each upcoming procedure, we provide the recommended input use for three randomly chosen candidate inputs. We ensure that only 1 of the three items is inexpensive in order to weigh our treatment toward higher value items.
Second, treated individuals have access to a website that includes a table of thresholds for all candidate inputs. Staff can use this website to check thresholds for inputs that are not included in the message and for unscheduled surgeries (due to emergency or last minute schedule changes).
Third, treated surgeons and nurses will receive a bi-weekly feedback message containing a figure that summarizes the actual usage of candidate inputs during the surgeries they conducted over the last 14 days, compared to the recommended amounts.
For details on how we chose candidate inputs, please see the pre-analysis plan.
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Field
Intervention Start Date
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Before
April 10, 2022
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After
June 20, 2022
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Field
Intervention End Date
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Before
October 28, 2022
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After
December 31, 2022
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Field
Experimental Design (Public)
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Before
All nurses and all surgeons in the Operating Rooms department will be invited to participate in the study via individual “introductory meetings” with the Study Coordinators in the month prior to the start of the study. During the meeting, the Study Coordinator will administer a short baseline survey to all participating nurses and doctors, discussed in more detail below. After the baseline surveys are complete, we will conduct the randomization. Half of surgeons and half of nurses will be randomly assigned to the treatment group. This generates four types of teams: those with an untreated surgeon and an untreated nurse, those with just a treated surgeon, those with just a treated nurse, and those where both the surgeon and nurse are treated. The treatment period will last for ~9000 scheduled operations, which we estimate will take 6 months. At the end of the treatment period, we conduct an endline survey with nurses and surgeons.
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After
All nurses and all surgeons in the Operating Rooms department will be invited to participate in the study via individual “introductory meetings” with the Study Coordinators in the months prior to the start of the study. During the meeting, the Study Coordinator will administer a short baseline survey to all participating nurses and doctors. After the baseline surveys are complete, we conduct the randomization. Half of surgeons and half of nurses are randomly assigned to the treatment group. This generates four types of teams, with different combinations of untreated and treated nurses and surgeons. The treatment period is planned to last for 9000 scheduled operations, which we estimate will take roughly 6 months. At the end of the treatment period, we conduct an endline survey with nurses and surgeons.
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Field
Planned Number of Clusters
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Before
110 nurses and 175 surgeons. This may change if some doctors and nurses do not consent to participate, which we will confirm when we complete the baseline survey.
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After
95 nurses and 156 surgeons.
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Field
Sample size (or number of clusters) by treatment arms
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Before
We will randomize such that 50% of nurses and 50% of doctors are treated. (This should amount to ~55 treated/untreated nurses, and ~87 treated/untreated surgeons, but the final numbers will depend on how many nurses/surgeons consent in the end.)
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After
Nurses: 47 treated, 48 untreated
Surgeons: 79 treated, 77 untreated
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