Table 1 Summary of included projects

Active Bathing to Eliminate Infection (ABATE Infection)

Does routine daily bathing with antiseptic soap for all patients plus targeted use of a nasal antibiotic ointment for MRSA carriers reduce multidrug resistant organisms and bloodstream infections in general medical, surgical, and oncology inpatient units?

Hospital Corporation of America (HCA)

Inpatients in non-critical care units at 53 U.S. HCA hospitals. Units where chlorhexidine bathing or nasal decolonization is common were excluded.

Cluster randomized trial of hospitals to compare two quality improvement strategies to reduce multidrug resistant organisms and bloodstream infections in non-critical care units. The two strategies to be evaluated are:

No changes of note.

Arm 1: Routine Care - Routine policy for showering/bathing

Arm 2: Decolonization - Use of chlorhexidine as routine soap for showering or bed bathing for all patients plus mupirocin × 5 days if MRSA+ by history, culture, or screen

A Pragmatic Trial of Lumbar Image Reporting with Epidemiology (LIRE)

Does adding epidemiologic benchmark data to spine imaging reports decrease subsequent back-related healthcare utilization?

Primary care clinics within the Kaiser Permanente-Northern California, Group Health Cooperative, Mayo Clinic Health System, and Henry Ford Health System

Approximately 150,000 adults for whom a primary care provider has requested imaging of the lumbar spine

Cluster randomized trial comparing typical imaging reports to those that include benchmarks prevalence data of findings in patients without back pain.

Clinics with a single provider were excluded, making recruitment slightly more restricted.

Collaborative Care for Chronic Pain in Primary Care (PPACT)

Does an interdisciplinary team-based program sited in primary care help patients manage chronic pain?

Primary practices in three Kaiser Permanente regions

Approximately 1,000 patients prioritized by their providers who have nonmalignant chronic pain and who are on long-term opioid therapy.

Mixed-methods cluster-randomized trial comparing multispecialty services within the primary care setting to usual care. The intervention is an integrated, interdisciplinary program that guides all pain-related care for intervention patients. It is embedded into everyday clinical practice flow utilizing assessment measures and intervention staff directly from the clinical care system.

Study infrastructure built to support and bolster EMR-based patient reported outcome data collection.

Strategies and Opportunities to Stop Colon Cancer in Priority Populations (STOP CRC)

Does an evidence-based, culturally tailored approach increase colorectal cancer screening in clinics that serve minority and low-income populations?

Federally Qualified Health Center clinics

30,000 patients aged 50 to 74 with no evidence of having had a recent colorectal cancer screening exam (fecal test, sigmoidoscopy or colonoscopy), and no history of colorectal disease.

Cluster randomized trial comparing usual care to intervention. The intervention consists of an automated data-driven, electronic health record-linked program for mailing FIT kits (with linguistically appropriate pictographic instructions and return postage) to patients due for CRC screening.

STOP CRC allowed patient reminders to be sent by email or letter and used a standard, well-validated quality improvement process (Plan-Do-Study-Act cycles) to facilitate program adaptations.

Time to Reduce Mortality in End-Stage Renal Disease (TiME)

Does systematically implementing a hemodialysis session duration of at least 4.25 hours improve survival, reduce hospitalizations and improve quality of life for patients with end-stage kidney disease?

Two large dialysis provider organizations

6432 patients with end stage renal disease treated by thrice weekly maintenance hemodialysis

Cluster-randomized, parallel-group clinical trial for patients initiating treatment with maintenance hemodialysis. Facilities are randomized in a 1:1 distribution to either:

Intervention arm: recommend dialysis session durations of at least 4.25 hours for all patients initiating hemodialysis treatment regardless of body size or dialysis solute clearance measurements, or

Usual care arm: no trial-driven approach to session duration.

24 hour urine collection eliminated and the quality of life survey was changed to the survey administered as part of routine care.