Video Images About Decisions for Ethical Outcomes in the Emergency Department (VIDEO-ED)
- Conditions
- Emergencies
- Interventions
- Behavioral: control arm ACP information sheetBehavioral: video decision aid
- Registration Number
- NCT04931797
- Lead Sponsor
- Massachusetts General Hospital
- 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.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 900
- anyone aged 65 and over or anyone aged over 50-64 with an indicator of serious illness
- non english or spanish speakers those with a POLST legally blind medically non stable requiring ICU level care
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Control arm control arm ACP information sheet Usual advance care planning services provided at the study site. Video video decision aid Video decision aid and advance care planning discussion
- Primary Outcome Measures
Name Time Method EHR documentation of advance care planning 3 months EHR documentation of advance care planning
- Secondary Outcome Measures
Name Time Method hospitalization at 3 and 6 months hospitalization
concordance between stated and documented preferences at 3 and 6 months concordance between stated and documented preferences
enrollment in hospice at 3 and 6 months enrollment in hospice
differential intervention effects of the ACP video intervention on patient ACP documentation based on race and ethnicity at baseline, 3 and 6 months We will look at ACP documentation in the intervention and control arms to see if there are differential intervention effects based on race and ethnicity. We will look at the ACP documentation rate in Whites in both arms, and compare them to African Americans and Latinx populations. We will be able to see if the intervention had a greater or lesser effect on ACP rates in sub groups of our population by race and ethnicity.
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 quality of ACP communication using an ACP quality communication survey
place of death at 3 and 6 months place of death
patient reported conversations with health care providers and family at 3 and 6 months patient reported conversations with health care providers and family
ACP documentation in the EHR at 6 months ACP documentation in the EHR
ED visits at 3 and 6 months ED visits
mortality at 3 and 6 months mortality
ICU days at 3 and 6 months ICU days
patient CPR and breathing machine preferences at time of survey (baseline) and then after 3 and 6 months we will ask the patient whether or not they want CPR attempted and whether they would wish to be placed on a breathing machine
patient confidence in health care delivery that is aligned with patient preferences at time of survey (baseline) and then after 3 and 6 months We will ask patients how confident they are in that they will receive the type of medical care they wish in their health care system
patient ACP engagement with ACP topics at baseline survey interview We will ask patients how ready and engaged they are with the topic of advance care planning
patient preferences for goals of care at time of survey (baseline) and then after 3 and 6 months We will ask patient if they wish to receive life prolonging care, limited care or comfort care.
decisional certainty regarding decision making for ACP preferences at baseline survey interview we will ask patients how certain they are about their decisions for the goals of care
patient knowledge of ACP at baseline survey interview We will ask patients knowledge questions about their understanding of advance care planning
Trial Locations
- Locations (4)
UC Davis
🇺🇸Davis, California, United States
Newton Wellesley Hospital
🇺🇸Newton, Massachusetts, United States
Brigham and Women's Hospital
🇺🇸Boston, Massachusetts, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States