Implementing, Evaluating, and Scaling Up of the Strengthening a Palliative Approach in Long Term Care (SPA-LTC) Program
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 594
- 试验地点
- 4
- 主要终点
- Number of Emergency Department Visits in the Resident's Last Year of Life
研究概览
简要总结
This study will evaluate the implementation of the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) program using a cross-jurisdictional, effectiveness-implementation type II hybrid design (dual testing of clinical and implementation interventions) to assess the implementation (feasibility, fidelity, reach, sustainability) and effectiveness (family satisfaction, staff knowledge and confidence implementing a palliative approach to care, hospital use).
详细描述
The SPA-LTC program has been developed and refined through prior participatory action based studies.
Evidence-based components of the program include:
Palliative Champion Teams; Palliative Care Education, including illness-trajectory pamphlets for staff and family members; Comfort Care Rounds with staff; Prognostic Tools to trigger end-of-life discussions; Palliative Care Conferences; Bereavement Pamphlets for families; and Post-Bereavement Follow-Up for families, and staff
The goal is to implement and assess this program across three provinces in Canada (Ontario, Saskatchewan, Manitoba). The investigators will use the findings to revise the program and inform the scaling up of the program across diverse settings and provinces.
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
- None
盲法说明
There is no need to mask participants, clinicians or research staff.
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •English-speaking LTC residents with a score of 50% or less on the Palliative Performance Scale.
排除标准
- •Non-English speaking LTC residents
- •residents with a score of more than 50% on the Palliative Performance Scale.
研究组 & 干预措施
Intervention
Within the intervention arm 9 long-term care homes will receive the SPA-LTC program:3 in Ontario; 3 in Saskatchewan and 3 in Manitoba.
干预措施: Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) Program (Other)
Control
Within the control arm 9 long-term care homes will receive the standard of care: 3 in Ontario; 3 in Saskatchewan and 3 in Manitoba.
结局指标
主要结局
Number of Emergency Department Visits in the Resident's Last Year of Life
时间窗: All residents in the home who died one year prior to the implementation and one year prior to the date of death for all residents in the home who die during the study intervention period.
次要结局
- Number of Hospital Deaths during the trial(Chart audit at start of the trial to capture data on residents who died in the year prior to the trial. Chart audits also during the transition phase prior to Steps 2 and 3; and one month after the intervention period for the trial ends.)
- Family Perceptions of End of Life Care(Survey completed at enrolment into the study; survey completed 2 months after the Family Care Conference or 1 month after the end of the intervention period if no Family Care Conference occurred.)
- Staff Knowledge about a Palliative Approach to Care(All staff in all participating long-term care homes will complete a staff survey at 2 points in the study: at the beginning and the end of the intervention)
- Number of Hospital Transfers per Resident(Chart audit at start of the trial to capture data on residents who died in the year prior to the trial. Chart audits also during the transition phase prior to Steps 2 and 3; and one month after the intervention period for the trial ends.)
- Family Experiences with End of Life Care(Interview completed at enrolment into the study; survey completed 2 months after the Family Care Conference or 1 month after the end of the intervention period if no Family Care Conference occurred.)
- Bereaved Family Satisfaction with End of Life Care(6 weeks to 2 months after the resident's death)
- Resident Satisfaction with End of Life Care(At the time of enrolment and 2 months after the Family Care Conference or 1 month after the intervention period if no Family Care Conference occurred.)