Recruiting

Observational Study

Sponsor:

Children's National Research Institute

Code:

NCT05488080

Conditions

Pain

Appendicitis

Bias, Racial

Fractures, Bone

Eligibility Criteria

Sex: All

Age: 0+

Healthy Volunteers: Not accepted

Interventions

Department-level audit and feedback and electronic health record-embedded clinical decision support

Study Details

Brief summary:

Racial and ethnic inequities in health care quality have been described across a broad range of clinical settings, patient populations, and outcomes. Our overarching goal is to eradicate health care inequities through evidence-based interventions. The objectives of this proposal are to develop and test the impact of two interventions on overcoming clinician implicit bias and mitigating inequities in the management of pain among children seeking care in the emergency department for the treatment of appendicitis or long bone fractures.

Conditions

Pain

Appendicitis

Bias, Racial

Fractures, Bone

Study ID

NCT05488080

Start date

Feb 27, 2023

Status verified date

Jul, 2025

Completion date

Aug 23, 2026

Anticipated

Primary completion date

Aug 23, 2026

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 0+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • All Children's National Hospital Emergency Department clinicians
  • Patients 0-21 years with symptoms suggestive of appendicitis or long bone fracture

Exclusion Criteria:

  • Emergency Severity Index (ESI 1)

Study Design

Enrollment

22032 participants

Anticipated

Intervention Model

Single group

Primary purpose

Health Services Research

Interventions and Outcome Measures

Arms

experimental: Department-level audit and feedback and electronic health record-embedded clinical decision support

Clinicians will receive monthly pooled, department-level 'Equity Report Cards' that will provide aggregate information on clinical data stratified by patient race/ethnicity. Subsequently, for all visits that may be related to appendicitis or long bone fracture, clinicians will then receive real-time, electronic health record-embedded clinical decision support regarding pain management.

Interventions

Department-level audit and feedback and electronic health record-embedded clinical decision support

This intervention will provide clinicians with Equity Report Cards and clinician decision support on mitigating disparities in quality of care.

Primary outcome measure

  • Pain reduction [ Time Frame: Equity Report Cards provided monthly to clinicians over a 24-month period ]
  • Analgesia use [ Time Frame: Equity Report Cards provided monthly to clinicians over a 24-month period ]

Central Contacts and Locations

Central contacts

Monika Goyal, MD

2024762869mgoyal@cnmc.org

Meleah Boyle

2024765388mdboyle@childrensnational.org

Locations

Children's National Hospital

Recruiting

Washington D.C., District of Columbia, United States, 20016-1838

Contacts

Monika Goyal

2024762869mgoyal@cnmc.org

More Information

Sponsor

Children's National Research Institute

Last update posted

Jul 17, 2025

Last verified

Jul, 2025

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Children's National Research Institute on 2025-07-17.