The cirrhosis care Alberta (CCAB) protocol: implementing an evidence-based best practice order set for the management of liver cirrhosis - a hybrid type I effectiveness-implementation trial

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dc.contributor.authorCarbonneau, Michelle
dc.contributor.authorEboreime, Ejemai A
dc.contributor.authorHyde, Ashley
dc.contributor.authorCampbell-Scherer, Denise
dc.contributor.authorFaris, Peter
dc.contributor.authorGramlich, Leah
dc.contributor.authorTsuyuki, Ross T
dc.contributor.authorCongly, Stephen E
dc.contributor.authorShaheen, Abdel A
dc.contributor.authorSadler, Matthew
dc.contributor.authorZeman, Marilyn
dc.contributor.authorSpiers, Jude
dc.contributor.authorAbraldes, Juan G
dc.contributor.authorSugars, Benjamin
dc.contributor.authorSia, Winnie
dc.contributor.authorGreen, Lee
dc.contributor.authorAbdellatif, Dalia
dc.contributor.authorSchaefer, Jeffrey P
dc.contributor.authorSelvarajah, Vijeyakumar
dc.contributor.authorMarr, Kaleb
dc.contributor.authorRyan, David
dc.contributor.authorWestra, Yolande
dc.contributor.authorBakshi, Neeja
dc.contributor.authorVarghese, Jayant C
dc.contributor.authorTandon, Puneeta
dc.date.accessioned2020-06-21T00:05:32Z
dc.date.available2020-06-21T00:05:32Z
dc.date.issued2020-06-18
dc.date.updated2020-06-21T00:05:32Z
dc.description.abstractAbstract Background Liver cirrhosis is a leading cause of morbidity, premature mortality and acute care utilization in patients with digestive disease. In the province of Alberta, hospital readmission rates for patients with cirrhosis are estimated at 44% at 90 days. For hospitalized patients, multiple care gaps exist, the most notable stemming from i) the lack of a structured approach to best practice care for cirrhosis complications, ii) the lack of a structured approach to broader health needs and iii) suboptimal preparation for transition of care into the community. Cirrhosis Care Alberta (CCAB) is a 4-year multi-component pragmatic trial which aims to address these gaps. The proposed intervention is initiated at the time of hospitalization through implementation of a clinical information system embedded electronic order set for delivering evidence-based best practices under real-world conditions. The overarching objective of the CCAB trial is to demonstrate effectiveness and implementation feasibility for use of the order set in routine patient care within eight hospital sites in Alberta. Methods A mixed methods hybrid type I effectiveness-implementation design will be used to evaluate the effectiveness of the order set intervention. The primary outcome is a reduction in 90-day cumulative length of stay. Implementation outcomes such as reach, adoption, fidelity and maintenance will also be evaluated alongside other patient and service outcomes such as readmission rates, quality of care and cost-effectiveness. This theory-based trial will be guided by Normalization Process Theory, Consolidated Framework on Implementation Research (CFIR) and the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) Framework. Discussion The CCAB project is unique in its breadth, both in the comprehensiveness of the multi-component order set and also for the breadth of its roll-out. Lessons learned will ultimately inform the feasibility and effectiveness of this approach in “real-world” conditions as well as adoption and adaptation of these best practices within the rest of Alberta, other provinces in Canada, and beyond. Trial registration ClinicalTrials.gov: NCT04149223, November 4, 2019.
dc.identifier.citationBMC Health Services Research. 2020 Jun 18;20(1):558
dc.identifier.doihttps://doi.org/10.1186/s12913-020-05427-8
dc.identifier.urihttp://hdl.handle.net/1880/112210
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleThe cirrhosis care Alberta (CCAB) protocol: implementing an evidence-based best practice order set for the management of liver cirrhosis - a hybrid type I effectiveness-implementation trial
dc.typeJournal Article
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