Randomization
SECONDARY
The cluster randomization was performed at the hospital level centrally using a computer-generated random number sequence. The other members of the study team and the selected sites were informed that they would cross over to the intervention period 1 month before each of the predefined steps to maintain allocation concealment while aiding in training logistics. A total of 17 hospitals were randomly assigned to 1 of the 3 sequences (cohorts) considering hospital location and level to minimize potential imbalance between the intervention and control periods as much as possible. Of the 51 participating hospitals (17 secondary and 34 tertiary hospitals), 2 (1 secondary hospital and 1 tertiary hospital) withdrew from this trial because they were unable to recruit eligible patients, and 1 hospital discontinued the study before the intervention and was replaced by a newly enrolled hospital with the same hospital level.