Clinical Research Directory

Inclusion Criteria: 1. Patient-level: All adult inpatients (\>=18 years of age) discharged within the baseline evaluation period and follow up period will be included in a physician report if they match the following criteria: a) Total in-hospital length of stay (LOS) is less than or equal to 14 days; b) and admitted to or discharged from a general medicine or hospitalist ward; c) admitted via the emergency department. 2. Physician-level: Physicians will be included if they have at least 50 hospitalizations attributed to them during the baseline period. Physicians who practice at multiple sites will only be included at the hospital with more encounters. 3. Hospital-level: In total, 29 teaching and community hospitals that provide data to GEMINI, with comprehensive geographic coverage of Ontario, will be included in this trial. Exclusion Criteria: 1. Patient-level: All data from ICU dates of care will be excluded from the trial (defined by ICU admission start and stop dates). All antimicrobial use data from ICU dates will be censored and excluded from attribution to GM physicians. Additionally, all patients with ICD-10-CA code Z51.5 for palliative care will be excluded owing to expected differences in antimicrobial management strategies. 2. Physician-level: No additional exclusion criteria will be used. 3. Hospital-level: Two hospitals in the GEMINI network will be excluded from this trial due to their lack of GM wards (a cancer hospital and a COVID-19 reactivation hospital). Additionally, any hospitals in the GEMINI network that do not meet annual data quality standards for antimicrobial use or other data fields will not be included in the trial.