Clinical Trial: Palliative Care Population Management Project for Integrated Care Management Program for High-Risk Patients

Study Status: Active, not recruiting
Recruit Status: Active, not recruiting
Study Type: Interventional

Official Title: Palliative Care Population Management Project for Integrated Care Management Program for High-Risk Patients

Brief Summary: The hypothesis of the Serious Illness Care Program (SICP) is that adherence to the Serious Illness Conversation Guide (SICG) portion, the SIGC, will enhance patient understanding and allow control over their own decisions, relieve burdens of decision-making on family members, and help patients achieve a state of peace as they approach the end of life.

Detailed Summary: The aim of the Serious Illness Care Program (SICP) is to provide clinicians with an evidence-based structure for eliciting and documenting vital information about preferences for patient driven care of their serious illness. It is designed to help open the door for patients, families, and clinicians to talk and reflect on end-of-life issues in an ongoing way. The hypothesis of the Serious Illness Care Program is that adherence to the conversation guide portion, the SIGC, will enhance patient understanding and allow control over their own decisions, relieve burdens of decision-making on family members, and help patients achieve a state of peace as they approach the end of life. For this protocol specifically, the investigators are testing a pilot intervention of a quality improvement project; the investigators plan to train clinicians and assess the feasibility and impact of the Serious Illness Care Program, which includes patient identification, clinician training, "triggering" of clinicians to conduct the SICG conversation, and documentation, in the iCMP at the Brigham and Women's Hospital.
Sponsor: Brigham and Women's Hospital

Current Primary Outcome: Percentage of eligible patients with documented goals of care conversations [ Time Frame: from date of determination of eligibility to date of death death during the study period, assessed for up to 18 months ]

For patients whose death falls during the study period, the percentage of goals of care conversations completed and documented in the electronic medical record by clinicians in the intervention group and the control group. A completed conversation is defined by key elements being documented regarding goals of care in the patient's medical record.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Median number of days before death of first documented goals of care conversation [ Time Frame: from date of determination of eligibility to date of death during the study period, assessed for up to 18 months ]
    For all patients whose death falls during the study period, the median number of days from the date of the first documented goals of care conversation to date of death in both the intervention and the control group.
  • Percentage of eligible patients with more comprehensive documentation of goals of care before death [ Time Frame: from date of determination of eligibility to date of death during study period, assessed for up to 18 months ]
    For all patients whose death falls during the study period, the percentage of patients with more comprehensive goals of care documentation before death in both the intervention group and the control group. More comprehensive is defined as documentation of a goals of care conversation that addresses more than code status only and will be evaluated for completeness in containing more key elements of a Serious Illness Care Guide conversation.


Original Secondary Outcome: Same as current

Information By: Brigham and Women's Hospital

Dates:
Date Received: May 7, 2015
Date Started: March 2014
Date Completion: December 2016
Last Updated: August 22, 2016
Last Verified: August 2016