Using the Emergency Department Visit to Promote Advance Care Planning
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 900
- 试验地点
- 8
- 主要终点
- EHR documentation of advance care planning
研究概览
简要总结
A randomized controlled trial of a video decision aid in the Emergency Department Setting to improve advance care planning documentation.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Single (Outcomes Assessor)
盲法说明
Primary outcome will be obtained through natural language processing (NLP) from the EHR, in which the RA conducting the NLP will not know which arm of the study the patient was in.
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •anyone aged 65 and over or anyone aged over 50-64 with an indicator of serious illness
排除标准
- •non english or spanish speakers those with a POLST legally blind medically non stable requiring ICU level care
结局指标
主要结局
EHR documentation of advance care planning
时间窗: 3 months
EHR documentation of advance care planning
次要结局
- 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)
研究者
Angelo E. Volandes, MD
Physician
Massachusetts General Hospital