Reducing overuse of antibiotics at discharge: the road home trial
Active Project Grant Awarded Last action
- Award ID
- R01HS029482
- Recipient
-
University Of Utah UEI LL8GLEVH6MG3
- Awarding agency
-
Division of Grants Management
Agency for Healthcare Research and Quality, Department of Health and Human Services
- Obligated
- $1,000,000
Award facts
- Assistance listing
- 93.226 Research on Healthcare Costs, Quality and Outcomes
- Completion date 63% complete
- Funding agency
- Center for Quality Improvement and Patient Safety Agency for Healthcare Research and Quality, Department of Health and Human Services
- Place of performance
- Salt Lake City, UT 84132, USA
Award details come from USAspending.gov.
Description
- Abstract
- The reducing overuse of antibiotics at discharge (road) home trial is a 40-hospital cluster randomized trial to evaluate the effectiveness and understand factors influencing implementation of the road home intervention. Antibiotic overuse at hospital discharge is common, costly, and harmful. While evidence-based antibiotic stewardship strategies exist to improve prescribing, they are not reaching patients as they transition across care settings. Hospital discharge represents one care transition in critical need of effective stewardship interventions that can be used across a variety of contexts. In the US, antibiotics prescribed at discharge account for half of antibiotic use-and up to 90% of days of overuse-related to hospitalization. Discharge- specific stewardship strategies (e.g., audit and feedback at discharge) are effective at optimizing prescribing; however, they are resource-intensive and often infeasible to implement across hospitals with variable resources. Thus, there is a critical need for interventions to improve discharge prescribing that are tailored to local context, feasible, and effective for diverse hospitals. To address this need, the road home study team developed the road home framework which specifies evidence-based stewardship strategies to improve discharge antibiotic prescribing. The road home framework is the foundation for the road home intervention, a participatory intervention that supports hospitals in implementing evidence-based stewardship strategies to improve discharge antibiotic use. The road home intervention includes three components: 1) discharge stewardship needs assessment, 2) facilitated selection of strategies using the road home framework, and 3) an implementation blueprint. The overarching goal of this study is to evaluate the effectiveness and understand the implementation context of the road home intervention. The central hypothesis is that hospitals participating in the road home intervention will have fewer days of antibiotic overuse at discharge compared to usual care hospitals. The proposed trial will leverage the researcher's extensive prior success conducting antibiotic stewardship research with the michigan hospital medicine safety consortium (HMS), a group of 69 hospitals working to improve care for hospitalized patients. The specific aims are: (1) within HMS, conduct a 40-hospital parallel cluster randomized trial to test the effectiveness of the road home intervention on days of antibiotic overuse at discharge in hospitalized adults with cap and UTI, (2) conduct a mixed-methods concurrent process evaluation to identify contextual factors influencing implementation of the road home intervention, and (3) create and refine a road home discharge stewardship toolkit. There is an urgent need to improve antibiotic prescribing at hospital discharge. Building on prior ahrq-funded work, this study will rigorously evaluate the innovative road home intervention and inform broad national dissemination efforts to ensure that reductions in harm and improvements in quality due to antibiotic stewardship are equitably distributed, reaching all patients regardless of where they receive care.
Transactions
| Action | Obligated | Date |
|---|---|---|
| Amendment | $500,000 | |
| Original award | $500,000 |
Subawards
| Subrecipient | Amount | Awarded |
|---|---|---|
| Regents Of The University Of Michigan | $134,410 | |
| Mymichigan Health | $40,061 |
Quick answers
Who received award R01HS029482?
R01HS029482 was awarded to University Of Utah by Division of Grants Management (Agency for Healthcare Research and Quality) on September 1, 2023.
How much is award R01HS029482 worth?
$1,000,000 has been obligated on R01HS029482.
Which agency awarded R01HS029482?
Division of Grants Management (Agency for Healthcare Research and Quality) awarded R01HS029482, with funding from Center for Quality Improvement and Patient Safety (Agency for Healthcare Research and Quality).
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