Trial Outcomes & Findings for Palliative Care Educator (NCT NCT04857060)

NCT ID: NCT04857060

Last Updated: 2026-01-12

Results Overview

Any documentation of a discussion pertaining to limitations of life sustaining treatment, palliative care, hospice, goals of care, time-limited trial, or surrogate decision makers.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 11174 participants
• Primary outcome timeframe: 12 months
• Results posted on: 2026-01-12

Participant Flow

This study included patients aged 65 years or older and their caregivers admitted to 1 of 14 units at two urban hospitals in New York and Boston from July 1, 2021, to October 31, 2022.

Of the 11,174 participants, 6,201 participants were randomized into the intervention.

Unit of analysis: Inpatient unit

Participant milestones

Measure	Step 0: 2 Months Usual Care Then 14 Months ACP Educator Led, Video Assisted Discussion For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Step 1: 4 Months Usual Care, Then 10 Months ACP Educator Led, Video Assisted Discussion For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Step 2: 6 Months Usual Care, Then 8 Months ACP Educator Led, Video Assisted Discussion For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Step 3: 8 Months Usual Care, Then 6 Months ACP Educator Led, Video Assisted Discussion For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Step 4: 10 Months Usual Care, Then 4 Months ACP Educator Led, Video Assisted Discussion For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Step 5: 12 Months Usual Care, Then 2 Months ACP Educator Led, Video Assisted Discussion For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Step 6: 14 Months Usual Care, Then 0 Months ACP Educator Led, Video Assisted Discussion For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.
Control: Usual Care (Caregiver) COMPLETED	4 2	28 2	39 2	33 2	27 2	31 2	32 2
Control: Usual Care (Patients) STARTED	1698 2	1190 2	853 2	543 2	357 2	88 2	50 2
Control: Usual Care (Patients) COMPLETED	1698 2	1190 2	853 2	543 2	357 2	88 2	50 2
Control: Usual Care (Patients) NOT COMPLETED	0 0	0 0	0 0	0 0	0 0	0 0	0 0
Intervention:Video Discussion (Patients) STARTED	263 2	495 2	650 2	979 2	1178 2	1212 2	1246 2
Intervention:Video Discussion (Patients) COMPLETED	263 2	495 2	650 2	979 2	1178 2	1212 2	1246 2
Intervention:Video Discussion (Patients) NOT COMPLETED	0 0	0 0	0 0	0 0	0 0	0 0	0 0
Control: Usual Care (Caregiver) STARTED	4 2	28 2	39 2	33 2	27 2	31 2	32 2
Control: Usual Care (Caregiver) NOT COMPLETED	0 0	0 0	0 0	0 0	0 0	0 0	0 0
Intervention:Video Discussion(Caregiver) STARTED	8 2	18 2	15 2	34 2	30 2	19 2	54 2
Intervention:Video Discussion(Caregiver) COMPLETED	8 2	18 2	15 2	34 2	30 2	19 2	54 2
Intervention:Video Discussion(Caregiver) NOT COMPLETED	0 0	0 0	0 0	0 0	0 0	0 0	0 0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

The row population differs from the overall to show the difference between patients and caregivers.

Baseline characteristics by cohort

Measure	ACP Educator Led, Video Assisted Discussion n=6208 Participants For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Usual Care n=4985 Participants Subjects in this arm do not meet with ACP Educator during their index hospitalization.	Total n=11193 Participants Total of all reporting groups
Age, Continuous Patient	78 years STANDARD_DEVIATION 8 • n=6023 Participants • The row population differs from the overall to show the difference between patients and caregivers.	78 years STANDARD_DEVIATION 8 • n=4779 Participants • The row population differs from the overall to show the difference between patients and caregivers.	78 years STANDARD_DEVIATION 8 • n=10802 Participants • The row population differs from the overall to show the difference between patients and caregivers.
Age, Continuous Caregivers	57 years STANDARD_DEVIATION 13 • n=178 Participants • The row population differs from the overall to show the difference between patients and caregivers.	57 years STANDARD_DEVIATION 13 • n=194 Participants • The row population differs from the overall to show the difference between patients and caregivers.	57 years STANDARD_DEVIATION 13 • n=372 Participants • The row population differs from the overall to show the difference between patients and caregivers.
Sex/Gender, Customized Patients · Female	2888 Participants n=6023 Participants • The rows are different to represent both caregivers and patients included in the analysis	2335 Participants n=4779 Participants • The rows are different to represent both caregivers and patients included in the analysis	5223 Participants n=10802 Participants • The rows are different to represent both caregivers and patients included in the analysis
Sex/Gender, Customized Patients · Male	3135 Participants n=6023 Participants • The rows are different to represent both caregivers and patients included in the analysis	2444 Participants n=4779 Participants • The rows are different to represent both caregivers and patients included in the analysis	5579 Participants n=10802 Participants • The rows are different to represent both caregivers and patients included in the analysis
Sex/Gender, Customized Patients · Unknown or not reported	0 Participants n=6023 Participants • The rows are different to represent both caregivers and patients included in the analysis	0 Participants n=4779 Participants • The rows are different to represent both caregivers and patients included in the analysis	0 Participants n=10802 Participants • The rows are different to represent both caregivers and patients included in the analysis
Sex/Gender, Customized Caregivers · Female	119 Participants n=178 Participants • The rows are different to represent both caregivers and patients included in the analysis	129 Participants n=194 Participants • The rows are different to represent both caregivers and patients included in the analysis	248 Participants n=372 Participants • The rows are different to represent both caregivers and patients included in the analysis
Sex/Gender, Customized Caregivers · Male	52 Participants n=178 Participants • The rows are different to represent both caregivers and patients included in the analysis	64 Participants n=194 Participants • The rows are different to represent both caregivers and patients included in the analysis	116 Participants n=372 Participants • The rows are different to represent both caregivers and patients included in the analysis
Sex/Gender, Customized Caregivers · Unknown or not reported	7 Participants n=178 Participants • The rows are different to represent both caregivers and patients included in the analysis	1 Participants n=194 Participants • The rows are different to represent both caregivers and patients included in the analysis	8 Participants n=372 Participants • The rows are different to represent both caregivers and patients included in the analysis
Ethnicity (NIH/OMB) Patients · Hispanic or Latino	548 Participants n=6023 Participants • The rows differ to represent patient and caregiver data	451 Participants n=4779 Participants • The rows differ to represent patient and caregiver data	999 Participants n=10802 Participants • The rows differ to represent patient and caregiver data
Ethnicity (NIH/OMB) Patients · Not Hispanic or Latino	5337 Participants n=6023 Participants • The rows differ to represent patient and caregiver data	4200 Participants n=4779 Participants • The rows differ to represent patient and caregiver data	9537 Participants n=10802 Participants • The rows differ to represent patient and caregiver data
Ethnicity (NIH/OMB) Patients · Unknown or Not Reported	138 Participants n=6023 Participants • The rows differ to represent patient and caregiver data	128 Participants n=4779 Participants • The rows differ to represent patient and caregiver data	266 Participants n=10802 Participants • The rows differ to represent patient and caregiver data
Ethnicity (NIH/OMB) Caregivers · Hispanic or Latino	23 Participants n=178 Participants • The rows differ to represent patient and caregiver data	18 Participants n=194 Participants • The rows differ to represent patient and caregiver data	41 Participants n=372 Participants • The rows differ to represent patient and caregiver data
Ethnicity (NIH/OMB) Caregivers · Not Hispanic or Latino	149 Participants n=178 Participants • The rows differ to represent patient and caregiver data	171 Participants n=194 Participants • The rows differ to represent patient and caregiver data	320 Participants n=372 Participants • The rows differ to represent patient and caregiver data
Ethnicity (NIH/OMB) Caregivers · Unknown or Not Reported	6 Participants n=178 Participants • The rows differ to represent patient and caregiver data	5 Participants n=194 Participants • The rows differ to represent patient and caregiver data	11 Participants n=372 Participants • The rows differ to represent patient and caregiver data
Race (NIH/OMB) Patients · American Indian or Alaska Native	16 Participants n=6023 Participants • The row differs to show patient and caregiver data collected	14 Participants n=4779 Participants • The row differs to show patient and caregiver data collected	30 Participants n=10802 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Patients · Asian	509 Participants n=6023 Participants • The row differs to show patient and caregiver data collected	386 Participants n=4779 Participants • The row differs to show patient and caregiver data collected	895 Participants n=10802 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Patients · Native Hawaiian or Other Pacific Islander	2 Participants n=6023 Participants • The row differs to show patient and caregiver data collected	3 Participants n=4779 Participants • The row differs to show patient and caregiver data collected	5 Participants n=10802 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Patients · Black or African American	1376 Participants n=6023 Participants • The row differs to show patient and caregiver data collected	1125 Participants n=4779 Participants • The row differs to show patient and caregiver data collected	2501 Participants n=10802 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Patients · White	3113 Participants n=6023 Participants • The row differs to show patient and caregiver data collected	2483 Participants n=4779 Participants • The row differs to show patient and caregiver data collected	5596 Participants n=10802 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Patients · More than one race	617 Participants n=6023 Participants • The row differs to show patient and caregiver data collected	454 Participants n=4779 Participants • The row differs to show patient and caregiver data collected	1071 Participants n=10802 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Patients · Unknown or Not Reported	390 Participants n=6023 Participants • The row differs to show patient and caregiver data collected	314 Participants n=4779 Participants • The row differs to show patient and caregiver data collected	704 Participants n=10802 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Caregivers · American Indian or Alaska Native	2 Participants n=178 Participants • The row differs to show patient and caregiver data collected	1 Participants n=194 Participants • The row differs to show patient and caregiver data collected	3 Participants n=372 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Caregivers · Asian	9 Participants n=178 Participants • The row differs to show patient and caregiver data collected	5 Participants n=194 Participants • The row differs to show patient and caregiver data collected	14 Participants n=372 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Caregivers · Native Hawaiian or Other Pacific Islander	0 Participants n=178 Participants • The row differs to show patient and caregiver data collected	0 Participants n=194 Participants • The row differs to show patient and caregiver data collected	0 Participants n=372 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Caregivers · Black or African American	61 Participants n=178 Participants • The row differs to show patient and caregiver data collected	63 Participants n=194 Participants • The row differs to show patient and caregiver data collected	124 Participants n=372 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Caregivers · White	84 Participants n=178 Participants • The row differs to show patient and caregiver data collected	110 Participants n=194 Participants • The row differs to show patient and caregiver data collected	194 Participants n=372 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Caregivers · More than one race	3 Participants n=178 Participants • The row differs to show patient and caregiver data collected	3 Participants n=194 Participants • The row differs to show patient and caregiver data collected	6 Participants n=372 Participants • The row differs to show patient and caregiver data collected
Race (NIH/OMB) Caregivers · Unknown or Not Reported	19 Participants n=178 Participants • The row differs to show patient and caregiver data collected	12 Participants n=194 Participants • The row differs to show patient and caregiver data collected	31 Participants n=372 Participants • The row differs to show patient and caregiver data collected
Region of Enrollment United States	6208 participants n=6208 Participants	4985 participants n=4985 Participants	11193 participants n=11193 Participants
Language English (Patient)	4909 participants n=6023 Participants • The rows differ to represent show the difference in caregiver and participant data	3864 participants n=4779 Participants • The rows differ to represent show the difference in caregiver and participant data	8773 participants n=10802 Participants • The rows differ to represent show the difference in caregiver and participant data
Language Spanish (Patient)	352 participants n=6023 Participants • The rows differ to represent show the difference in caregiver and participant data	315 participants n=4779 Participants • The rows differ to represent show the difference in caregiver and participant data	667 participants n=10802 Participants • The rows differ to represent show the difference in caregiver and participant data
Language Other (Patient)	707 participants n=6023 Participants • The rows differ to represent show the difference in caregiver and participant data	548 participants n=4779 Participants • The rows differ to represent show the difference in caregiver and participant data	1255 participants n=10802 Participants • The rows differ to represent show the difference in caregiver and participant data
Language Unknown or missing (Patient)	55 participants n=6023 Participants • The rows differ to represent show the difference in caregiver and participant data	52 participants n=4779 Participants • The rows differ to represent show the difference in caregiver and participant data	107 participants n=10802 Participants • The rows differ to represent show the difference in caregiver and participant data
Language English (Caregiver)	172 participants n=178 Participants • The rows differ to represent show the difference in caregiver and participant data	190 participants n=194 Participants • The rows differ to represent show the difference in caregiver and participant data	362 participants n=372 Participants • The rows differ to represent show the difference in caregiver and participant data
Language Spanish (Caregiver)	6 participants n=178 Participants • The rows differ to represent show the difference in caregiver and participant data	4 participants n=194 Participants • The rows differ to represent show the difference in caregiver and participant data	10 participants n=372 Participants • The rows differ to represent show the difference in caregiver and participant data
Language Other (Caregiver)	0 participants n=178 Participants • The rows differ to represent show the difference in caregiver and participant data	0 participants n=194 Participants • The rows differ to represent show the difference in caregiver and participant data	0 participants n=372 Participants • The rows differ to represent show the difference in caregiver and participant data
Language Unknown or missing (Caregiver)	0 participants n=178 Participants • The rows differ to represent show the difference in caregiver and participant data	0 participants n=194 Participants • The rows differ to represent show the difference in caregiver and participant data	0 participants n=372 Participants • The rows differ to represent show the difference in caregiver and participant data
Alzheimer's disease and related dementias diagnosis Yes	681 participants n=6023 Participants • The row population differs from the overall since data only from patients was collected about ADRD diagnosis, and not from caregivers.	570 participants n=4779 Participants • The row population differs from the overall since data only from patients was collected about ADRD diagnosis, and not from caregivers.	1251 participants n=10802 Participants • The row population differs from the overall since data only from patients was collected about ADRD diagnosis, and not from caregivers.
Alzheimer's disease and related dementias diagnosis No	5342 participants n=6023 Participants • The row population differs from the overall since data only from patients was collected about ADRD diagnosis, and not from caregivers.	4209 participants n=4779 Participants • The row population differs from the overall since data only from patients was collected about ADRD diagnosis, and not from caregivers.	9551 participants n=10802 Participants • The row population differs from the overall since data only from patients was collected about ADRD diagnosis, and not from caregivers.

PRIMARY outcome

Timeframe: 12 months

Any documentation of a discussion pertaining to limitations of life sustaining treatment, palliative care, hospice, goals of care, time-limited trial, or surrogate decision makers.

Outcome measures

Measure	ACP Educator Led, Video Assisted Discussion n=6023 Participants For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Usual Care (Control) n=4779 Participants Subjects in this arm do not meet with ACP Educator during their index hospitalization.
Identification of a Goals of Care Conversation in the Electronic Health Record (EHR) During the Index Hospitalization	3744 Participants	2396 Participants

SECONDARY outcome

Timeframe: Baseline, 12 months

Population: There was unanticipated high variability between receiving the intervention and the caregiver survey. Furthermore, a majority of the participants in the caregiver survey did not have any contact with the intervention at all. Accordingly, the survey activity was implemented in a fashion that did not reflect the intervention.

Medical records were reviewed for the presence and content of resuscitation and treatment preferences including: Full code, do not resuscitate (DNR), do not intubate (DNI), do not hospitalize (DNH), and documented preferences around feeding tubes, and dialysis. Change is measured as the number of patients with a new documented preference between baseline and 12 months.

Outcome measures

Measure	ACP Educator Led, Video Assisted Discussion n=6023 Participants For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Usual Care (Control) n=4779 Participants Subjects in this arm do not meet with ACP Educator during their index hospitalization.
Change in Documentation of Medical Orders for Resuscitation Preferences in EHR Hospice	597 count of documentation preferences	461 count of documentation preferences
Change in Documentation of Medical Orders for Resuscitation Preferences in EHR Time-limited trials	105 count of documentation preferences	20 count of documentation preferences
Change in Documentation of Medical Orders for Resuscitation Preferences in EHR Missing	0 count of documentation preferences	98 count of documentation preferences
Change in Documentation of Medical Orders for Resuscitation Preferences in EHR Goals Conversation	3562 count of documentation preferences	2258 count of documentation preferences
Change in Documentation of Medical Orders for Resuscitation Preferences in EHR Limitation of life-sustaining treatment	1979 count of documentation preferences	1242 count of documentation preferences
Change in Documentation of Medical Orders for Resuscitation Preferences in EHR Palliative care	2067 count of documentation preferences	700 count of documentation preferences

SECONDARY outcome

Timeframe: Baseline, 12 months

Population: There were unanticipated high variability between receiving the intervention and the caregiver survey. Furthermore, many of the participants in the caregiver survey did have any contact with the intervention at all. Accordingly, the survey activity was implemented in a fashion that did not reflect the intervention.

6 investigator designed questions to assess subject's knowledge of advance care planning, scores range 0-6, higher scores indicate greater knowledge

Outcome measures

Measure	ACP Educator Led, Video Assisted Discussion n=178 Participants For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Usual Care (Control) n=194 Participants Subjects in this arm do not meet with ACP Educator during their index hospitalization.
Caregiver Knowledge of ACP at 12 Months	4 score on a scale Interval 3.0 to 5.0	4 score on a scale Interval 3.0 to 5.0

SECONDARY outcome

Timeframe: Baseline, 12 months

Population: There was unanticipated high variability between receiving the intervention and the caregiver survey. Furthermore, a majority of the participants in the caregiver survey did not have any contact with the intervention at all. Accordingly, the survey activity was implemented in a fashion that did not reflect the intervention.

3 investigator designed questions with responses on a 5-point likert scale from lowest to highest confidence. Range of scores 3-15, higher scores are associated with more caregiver confidence.

Outcome measures

Measure	ACP Educator Led, Video Assisted Discussion n=178 Participants For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Usual Care (Control) n=194 Participants Subjects in this arm do not meet with ACP Educator during their index hospitalization.
Caregiver Confidence at 12 Months	15 score on a scale Interval 10.0 to 15.0	15 score on a scale Interval 9.0 to 15.0

SECONDARY outcome

Timeframe: Baseline, 12 months

Population: There were unanticipated high variability between receiving the intervention and the caregiver survey. Furthermore, many of the participants in the caregiver survey did have any contact with the intervention at all. Accordingly, the survey activity was implemented in a fashion that did not reflect the intervention.

10 investigator designed questions to assess subject's satisfaction with clinician communication. Scores range from 0-10 with higher scores indicating higher confidence. Range of scores 10-100, higher scores are associated with more satisfaction with clinician communication.

Outcome measures

Measure	ACP Educator Led, Video Assisted Discussion n=178 Participants For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Usual Care (Control) n=194 Participants Subjects in this arm do not meet with ACP Educator during their index hospitalization.
Caregiver Communication Satisfaction at 12 Months	31 score on a scale Interval 27.0 to 32.0	31 score on a scale Interval 26.0 to 32.0

SECONDARY outcome

Timeframe: Baseline, 12 months

Population: There was unanticipated high variability between receiving the intervention and the caregiver survey. Furthermore, a majority of the participants in the caregiver survey did not have any contact with the intervention at all. Accordingly, the survey activity was implemented in a fashion that did not reflect the intervention.

12 investigator designed questions with responses on a 5-point likert scale from lowest to highest satisfaction. Range of scores 12-60, higher scores are associated with more decisional satisfaction.

Outcome measures

Measure	ACP Educator Led, Video Assisted Discussion n=178 Participants For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Usual Care (Control) n=194 Participants Subjects in this arm do not meet with ACP Educator during their index hospitalization.
Caregiver Decisional Satisfaction at 12 Months	40 score on a scale Interval 33.0 to 42.0	40 score on a scale Interval 36.0 to 43.0

SECONDARY outcome

Timeframe: Baseline, 12 months

Population: There was unanticipated high variability between receiving the intervention and the caregiver survey. Furthermore, a majority of the participants in the caregiver survey did not have any contact with the intervention at all. Accordingly, the survey activity was implemented in a fashion that did not reflect the intervention.

2 investigator designed questions to assess level of certainty in decisions, scores range from 0-4 with highest scores indicating the highest certainty. Range of scores 0-8, higher scores are associated with more decisional certainty.

Outcome measures

Measure	ACP Educator Led, Video Assisted Discussion n=178 Participants For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids. ACP Educator led, video assisted discussion: For hospitalized patients identified by a defined EHR algorithm, an ACP Educator will meet with the patient in the hospital to provide primary palliative care services such as goals-of-care conversations and clinician communication by leveraging certified video decision aids.	Usual Care (Control) n=194 Participants Subjects in this arm do not meet with ACP Educator during their index hospitalization.
Caregiver Decisional Certainty	2 score on a scale Interval 2.0 to 2.0	2 score on a scale Interval 2.0 to 2.0

Adverse Events

ACP Educator Led, Video Assisted Discussion

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Usual Care

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Michael Paasche-Orlow

Tufts Medical Center

Phone: 617-636-1029

Email: michael.paasche-orlow@tuftsmedicine.org

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place