Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning Conversations by Hospitalists With Older Adults
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 1,261
- 试验地点
- 2
- 主要终点
- Incidence of Billed Advance Care Planning
研究概览
简要总结
Hopewell Hospitalist is a theory-based adventure video game designed to increase the likelihood that a physician will engage in an advance care planning (ACP) conversation with a patient over the age of 65. Drawing on the theory of narrative engagement, players assume the persona of a hospitalist physician and navigate a series of clinical encounters with seriously-ill patients over the age of 65. Players experience the consequences of having (or not having) ACP conversations in a timely fashion. The planned study is a crossover phase III trial testing the effectiveness of providing physicians with a link to a free version of Hopewell Hospitalist as a means for increasing ACP rates measured by ACP billing frequency.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Sequential
- 主要目的
- Health Services Research
- 盲法
- Single (Outcomes Assessor)
盲法说明
A physician's treatment assignment will be masked during analysis.
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Employed by Sound
- •Not previously included in the Efficacy Trial Arm of the study.
- •Hospitalist
排除标准
- •Not employed by Sound
- •Does not provide informed consent
- •Previously included in the Efficacy Trial Arm of the study.
结局指标
主要结局
Incidence of Billed Advance Care Planning
时间窗: 6 months (3 months pre and 3 months post intervention)
Change in physician advance care planning billing for patients over the age of 65 in the three months before and after the roll-out of the video game intervention at their hospital. Advance care planning billing is defined as the presence/absence of ACP charges (Medicare billing codes 99497 or 99498) during a physician's patient's hospitalization.
Merit-based Incentive Payment System Advance Care Planning Quality Score
时间窗: 6 months (3 months pre and 3 months post intervention)
Change in the Merit-based Incentive Payment System (MIPS) self-report measure of advance care planning by enrolled hospitalists (MiPS-ACP quality score). The MiPS-ACP quality score is the percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan. The quality score ranges from 0-100%, with higher scores indicating that a greater proportion of patients with an advance care plan documented in the medical record.
次要结局
- Hospitalist-Managed Patient In-Hospital Mortality Rate(6 months (3 months pre and 3 months post intervention))
- Incidence of Hospitalist-Managed Patient Admission to ICU(6 months (3 months pre and 3 months post intervention))
- Incidence of Hospitalist-Managed Patient Mechanical Ventilation(6 months (3 months pre and 3 months post intervention))
- Incidence of Hospitalist-Managed Patient Receipt of Life-Sustaining Treatment(s)(6 months (3 months pre and 3 months post intervention))
- Hospitalist-Managed Patient 90-Day Mortality Rate(6 months (3 months pre and 3 months post intervention))
- Sum of Resources Utilized by Hospitalist-Managed Patients(6 months (3 months pre and 3 months post intervention))
- Hospitalist-Managed Patient Length of Stay(6 months (3 months pre and 3 months post intervention))
- Hospitalist-Managed Patient Disposition Status Type(6 months (3 months pre and 3 months post intervention))
- Hospitalist-Managed Patient 90-Day Episode-Based Spending(6 months (3 months pre and 3 months post intervention))
研究者
Amber Barnato
Susan J. and Richard M. Levy 1960 Distinguished Professor in Health Care Delivery
Dartmouth-Hitchcock Medical Center