Consent Cover Letter

SCORE-UC: Improving Antibiotic Use in Urgent Care Facilities Through Implementation
And Evaluation of Core Elements of Outpatient Antibiotic Stewardship
PI: Eddie Stenehjem, MD MSc

Version Date: 09.20.2021
Version: 5.0

Consent Cover Letter
IRB# 1050982
Study Title: SCORE - UC: Improving Antibiotic Use in Urgent Care Facilities
Through Implementation and Evaluation of Core elements of
Outpatient Antibiotic Stewardship
Principal Investigators: Eddie Stenehjem, MD MSc/ Adam Hersh MD PhD
Who is paying for the study?
Funding is provided by the Centers for Disease Control and Prevention
Do any of the researchers have a conflict of interest with this study?
The researchers have nothing to disclose.
Why is this study being done?
The purpose of this research is to pair clinical effectiveness researchers with
implementation science researchers in order to conduct a study implementing
evidence-based practices of appropriate antibiotic prescribing in the Urgent (UC)
setting. The specific aims are to perform a retrospective evaluation of antibiotic
prescription practices in Intermountain Healthcare UCs and evaluate the impact of
implementing antibiotic stewardship best practices into the UC setting.
What exams, tests and procedures are involved in this study?
We would like you to participate in a survey, so we may be able to determine the
barriers and facilitators to appropriate antibiotic prescribing in the Urgent Care
setting. This survey should take up to 10 minutes depending on your answers.
What risks can I expect from taking part in this study?
The only potential risk is the potential for breach of confidentiality. Your
responses will be de-identified and individual identification will not be reported to
others.
What are the benefits of taking part in this study?
There is no benefit to you for participating.
What are the alternatives to taking part in this study?
There is no alternative for participating other than not participating.
Will I receive results from this study?
The outcomes of this study will be reported to the Centers for Disease Control
and Prevention and will be published in future academic products which will be
made publicly available after publication.
Who will see my personal information?
Only authorized members of the study team may view the collected data.
Will any of my information or samples from this study be used for any

commercial profit?
There is no intent to use any of the data collected to develop a commercial forprofit product.
What are the costs of taking part in this study?
There is no financial cost to participate.
Where can I get more information?
If you have any questions complaints or if you feel you have been harmed by this
research,
please
contact
Dr.
Eddie
Stenehjem (801) 507-7781
([email protected]).
If you have questions regarding your rights as a research subject or if problems
arise which you do not feel you can discuss with the Investigator, please contact
Intermountain’s Office of Research at 1-800-321-2107.
Do I have to take part in this study?
Participation in this study is voluntary. You can choose not to take part.