Using the Emergency Department Visit to Promote Advance Care Planning

Massachusetts General Hospital4 sites in 1 country900 target enrollmentApril 25, 2022

ConditionsEmergencies

Overview

Phase: Not Applicable
Intervention: Not specified
Conditions: Emergencies
Sponsor: Massachusetts General Hospital
Enrollment: 900
Locations: 4
Primary Endpoint: EHR documentation of advance care planning
Status: Active, not recruiting
Last Updated: 5 months ago

Overview Investigators Eligibility Criteria Outcomes Sites Similar Trials

Overview

Brief Summary

A randomized controlled trial of a video decision aid in the Emergency Department Setting to improve advance care planning documentation.

Detailed Description

A randomized controlled trial of a video decision aid in the Emergency Department setting shown to patients followed by a brief advance care planning discussion and then relay that discussion to the patient's primary care provider and/or admitting clinical team and look at rates of advance care planning documentation in the electronic health record over time. Primary outcome is advance care planning documentation in the EHR at 3 months.

Registry

clinicaltrials.gov

Start Date

April 25, 2022

End Date

May 30, 2026

Last Updated

5 months ago

Study Type

Interventional

Study Design

Parallel

Sex

All

Investigators

Sponsor

Massachusetts General Hospital

Responsible Party

Principal Investigator

Angelo E. Volandes, MD

Physician

Massachusetts General Hospital

Eligibility Criteria

Inclusion Criteria

•anyone aged 65 and over or anyone aged over 50-64 with an indicator of serious illness

Exclusion Criteria

•non english or spanish speakers those with a POLST legally blind medically non stable requiring ICU level care

Outcomes

Primary Outcomes

EHR documentation of advance care planning

Time Frame: 3 months

EHR documentation of advance care planning

Secondary Outcomes

concordance between stated and documented preferences(at 3 and 6 months)
enrollment in hospice(at 3 and 6 months)
hospitalization(at 3 and 6 months)
differential intervention effects of the ACP video intervention on patient ACP documentation based on race and ethnicity(at baseline, 3 and 6 months)
quality of clinician ACP communication using an ACP quality communication survey(quality of communication at the time of the survey interview (baseline), and then at 3 and 6 months)
place of death(at 3 and 6 months)
patient reported conversations with health care providers and family(at 3 and 6 months)
ACP documentation in the EHR(at 6 months)
ED visits(at 3 and 6 months)
mortality(at 3 and 6 months)
ICU days(at 3 and 6 months)
patient CPR and breathing machine preferences(at time of survey (baseline) and then after 3 and 6 months)
decisional certainty regarding decision making for ACP preferences(at baseline survey interview)
patient confidence in health care delivery that is aligned with patient preferences(at time of survey (baseline) and then after 3 and 6 months)
patient knowledge of ACP(at baseline survey interview)
patient ACP engagement with ACP topics(at baseline survey interview)
patient preferences for goals of care(at time of survey (baseline) and then after 3 and 6 months)