Coaches Activating Reaching and Engaging Patients

Not Applicable

Completed

Brief Summary: The purpose of the Team Based Advance Care Planning CAREPLAN program is to understand if a trained lay navigator who engages with patients with advanced stages of cancer can help patients in advance care planning, improve patient activation, satisfaction, quality of life, and the quality of end of life cancer care while also ensuring goal concordant cancer care at the end of life.

Detailed Description: Stanford Cancer Institute plans to implement and evaluate several critical elements to be in alignment with the mission of the organization to provide high value care to their patients. The CAREPLAN (Coaches Activating, Reaching, and Engaging Patients in Their End of Life Care Plan) intervention is an innovative program aimed to strengthen provider-patient relationships and facilitate whole person care about matters important to patients diagnosed with advanced stages of cancer and important to patients' support network and family. The project is intended to help establish patients' Goals of Care Plan with appropriate documentation, develop, deploy, and evaluate a model of care for patients with cancer that is intended to improve clinical outcomes and their experiences with their cancer care. The intervention provides patients with lay navigators who assist them and their families in formulating and discussing their goals of care with their health care teams in hopes to engage in shared-decision making for goal concordant care. The goal of the project is to demonstrate that there is improved documentation of goals of care, patient experiences, patient activation, quality of life, and quality of care and communication and that the program helps to improve goal concordant care receipt at the end of life.

Recruitment & Eligibility

Inclusion Criteria

All patients who receive care at Stanford Cancer Institute and have genitourinary cancers and have received greater than 2 prior courses of chemotherapy treatment

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Control Group Arm	Usual Care	The control group will receive usual care as provided by their local oncologists.
Intervention Group Arm	Lay Navigator Intervention	Patients randomized into the intervention will be assigned a lay patient navigator who will provide information regarding early advance care planning, documentation of goals of care, and coordinating home-based care. The intervention arm will also receive usual care as provided by their local oncologists.
Intervention Group Arm	Usual Care	Patients randomized into the intervention will be assigned a lay patient navigator who will provide information regarding early advance care planning, documentation of goals of care, and coordinating home-based care. The intervention arm will also receive usual care as provided by their local oncologists.

Primary Outcome Measures

Name	Time	Method
Goals of Care Documentation	12 months after patient enrollment	Goals of Care documentation for each patient will be abstracted by electronic medical record chart review for each patient at 12 months after enrollment.

Secondary Outcome Measures

Name	Time	Method
Emergency Department Visit using chart abstraction	12 months after patient enrollment	Emergency Department Use for each patient will be assessed by electronic health record abstraction from time of enrollment to 12 months after patient enrollment
Hospice using chart abstraction	12 months after patient enrollment	Hospice for each patient will be assessed by electronic health record abstraction from time of enrollment to 12 months after patient enrollment
Palliative care using chart abstraction	12 months after patient enrollment	Palliative care use for each patient will be assessed by electronic health record abstraction from time of enrollment to 12 months after patient enrollment
Hospitalization Visit using chart abstraction	12 months after patient enrollment	Hospitalization Visits for each patient will be assessed by electronic health record abstraction from time of enrollment to 12 months after patient enrollment

Locations (1): Stanford University School of Medicine
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Stanford, California, United States