Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

EASY-NET Program: Effectiveness of an Audit and Feedback Intervention in the Emergency Care for Acute Conditions in Lazio Region

Laura Angelici
* ORCID logo ,
Carmen Angioletti
ORCID logo ,
Luigi Pinnarelli
,
Paola Colais
,
Antonio Giulio De Belvis
,
Andriy Melnyk
,
Emanuele La Gatta
,
Sara Farchi
,
Marina Davoli
ORCID logo ,
Nera Agabiti
,
Anna Acampora
ORCID logo
Version 1 : Received: 26 February 2024 / Approved: 26 February 2024 / Online: 26 February 2024 (12:43:48 CET)

A peer-reviewed article of this Preprint also exists.

Angelici, L.; Angioletti, C.; Pinnarelli, L.; Colais, P.; de Belvis, A.G.; Melnyk, A.; La Gatta, E.; Farchi, S.; Davoli, M.; Agabiti, N.; Acampora, A. EASY-NET Program: Effectiveness of an Audit and Feedback Intervention in the Emergency Care for Acute Conditions in the Lazio Region. Healthcare 2024, 12, 733. Angelici, L.; Angioletti, C.; Pinnarelli, L.; Colais, P.; de Belvis, A.G.; Melnyk, A.; La Gatta, E.; Farchi, S.; Davoli, M.; Agabiti, N.; Acampora, A. EASY-NET Program: Effectiveness of an Audit and Feedback Intervention in the Emergency Care for Acute Conditions in the Lazio Region. Healthcare 2024, 12, 733.

Abstract

The EASY-NET network program (NET-2016-02364191 - Effectiveness of Audit and Feedback (A&F) strategies to improve health practice and equity in various clinical and organizational set-tings), piloted a new and more structured A&F strategy. This study compared the effectiveness of the new strategy versus the periodic publication of indicators alone in improving the appropri-ateness and timeliness of emergency health interventions in patients with Acute Miocardial In-farction (AMI) and ischemic stroke in the Lazio Region. Efficacy was evaluated according to a prospective quasi-experimental design of pre-post (2021-2022) intervention type with control group. The exposed are hospitals in the Lazio Region where professional teams voluntarily par-ticipated in the intervention. The control group is involved only in the usual reporting activities. Effectiveness analysis was conducted at the patient level. Regional health information systems were used to calculate process and outcome indicators. The effectiveness of the intervention was assessed with Difference In Difference models, comparing pre-post intervention periods between exposures and controls. Estimates were calculated in terms of the difference in percentage points (pp) between absolute risks. Sixteen facilities for the IMA pathway and 13 for the stroke pathway joined the intervention. The intervention reduced the proportion of 30-days readmissions after a hospitalization for ischemic stroke by 0.54 pp in the exposed patients with a significant difference of -3.80 pp (IC95% -6.57; -1.03; 5453 patients, 63.7% cases) in the exposed compared to controls. There were no statistically significant differences attributable to the implemented A&F interven-tion in the other indicators considered. The results show, for the first time in Italy, the impact of A&F interventions in an emergency setting using aggregated data from hospitals involved in the Lazio Region emergency network.

Keywords

acute myocardial infarction; stroke; audit and feedback; emergency networks.

Subject

Public Health and Healthcare, Public Health and Health Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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