Quality Improvement Project for Advance Care Planning Tool in Hospital Medicine

NCT ID: NCT04296136

Last Updated: 2022-05-18

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 743 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2019-11-26
• Study Completion Date: 2022-03-15

Brief Summary

Hospitalized patients and their families are often unprepared regarding end-of-life care. Even patients with high risk of mortality within the index admission or 30 days after admission often do not have clearly defined goals of care. This lack of clarity can create difficult scenarios for patients, their families, and care providers. Lack of communication and documentation of these goals can lead to unnecessary tests, procedures, and readmissions. By creating advanced care planning education for the hospital medicine department, a standardized note template, and EMR utilization for storage and reference of patient's goals of care documentation we aim to facilitate the conveyance of patient's wishes/preferences across different care providers and across separate encounters within the healthcare system. For this study, we will use a pre-post study design to evaluate the implementation of this quality improvement intervention.

Conditions

Advance Care Planning

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: OTHER

Study Groups

High risk of mortality

Adult patients admitted to the hospital medicine service with a high risk of mortality

Advance Care Planning Discussion

Intervention Type: OTHER

Goals of care discussion with patient, documentation with electronic health record note and advance care planning billing. This will also include: pharmacy review of medications, case management review, and coding specialist review.

High risk of mortality (pre-implementation)

Adult patients admitted to the hospital medicine service with a high risk of mortality

No interventions assigned to this group

Interventions

Advance Care Planning Discussion

Goals of care discussion with patient, documentation with electronic health record note and advance care planning billing. This will also include: pharmacy review of medications, case management review, and coding specialist review.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• All patients admitted to the inpatient medicine service with high risk of mortality.

Exclusion Criteria

• Involuntary commitment during the index admission

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Duke University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Sendak Mark

Role: PRINCIPAL_INVESTIGATOR

Duke University

Locations

Duke University

Durham, North Carolina, United States

Countries

United States

Other Identifiers

Pro00104527

Identifier Type: -

Identifier Source: org_study_id