ImproveCare - The management of clinical uncertainty in hospital settings

Not Applicable

Completed

• Conditions: End of life care; Not Applicable

• Registration Number: ISRCTN36040085
• Lead Sponsor: King’s College London and King’s College Hospital NHS Foundation Trust

Brief Summary

2019 Results article in https://www.ncbi.nlm.nih.gov/pubmed/31419994 results (added 21/08/2019) 2019 Results article in https://www.ncbi.nlm.nih.gov/pubmed/31594555 results (added 10/10/2019) 2020 Other publications in https://pubmed.ncbi.nlm.nih.gov/32081088/ (added 24/02/2023) 2020 Other publications in https://pubmed.ncbi.nlm.nih.gov/32936837/ Multi-method process evaluation (added 24/02/2023)

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2017-01-18
• Study Completion: 2018-10-31
• Last Update Posted: 6 March 2023

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 65

Inclusion Criteria

Patient inclusion criteria:
1. Participants must be 18 or over
2. Participants can be female or male
3. Patients who are deteriorating
4. Patients whose situations are clinically uncertain, with limited reversibility
5. Patients at risk of dying during their current episode of care, despite treatment

Relative inclusion criteria:
Relative or close friends of the patients who fulfil the criteria above.

Healthcare professional inclusion criteria:
Working on the study wards.

Exclusion Criteria

Patient exclusion criteria:
1. Participants under 18 years old
2. Patients whose situations are clinically certain

Relative exclusion criteria:
Relatives or close friends of the patients who do not meet the inclusion criteria

Healthcare professional exclusion criteria:
Not working on the study wards

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<br> 1. The effect of the AMBER care bundle is measured using the Patient/family anxiety and communication subscale of the Integrated Palliative care Outcome Scale (I-POS) at baseline, 3-5 days, 10-15 days<br> 2. Patients reported experiences of health care are measured using the howRwe questionnaire at baseline, 3-5 days, 10-15 days<br>

Secondary Outcome Measures

Name	Time	Method
<br> 1. Cost of care is measured with the EQ-5D at baseline, 3-5 days, 10-15 days<br> 2. Other subscales of the Integrated Palliative Care Outcome Scale (I-POS) questionnaire at baseline, 3-5 days, 10-15 days<br> 3. What patients and carers value most about AMBER care bundle and how it may be working is assessed through qualitative interviews, focus groups and non-participatory observation of multidisciplinary team meetings<br> 4. Patients views on how they feel about taking part in this study are collected at 3-5 days and 10-15 days<br><br> Embedded qualitative study:<br> Preferred place of death and whether this is realized, along with satisfaction which will be collected from the relatives of patients who have lost their lives is measured using the QUALYCARE postal survey.<br>