Project to Improve Communication About Serious Illness - Pilot Study (PICSI-P)
Using the Electronic Health Record to Identify and Promote Goals-of-Care Communication
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Washington
-
Seattle, Washington, United States, 98195
- University of Washington Medical Center
-
Seattle, Washington, United States, 98104
- Harborview Medical Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria, Patients: meeting criteria for serious illness (encompassing multiple acute and chronic illnesses) including:
- those used by the Dartmouth Atlas to study end-of-life care in the US: malignant cancer/leukemia, chronic pulmonary disease, coronary artery disease, congestive heart failure, chronic liver disease, chronic renal disease, dementia, diabetes with end-organ damage, and peripheral vascular disease.
- patients over age 65 with markers of frailty: albumin level <3.0 within 48 hours of admission and weight loss of ≥10 pounds in the past year.
- hospitalized patients over age 80.
- English-speaking
Exclusion Criteria, Patients:
- unable to complete informed consent procedures and do not have a legal next of kin
- restricted information status (e.g. prisoners)
- pregnant
Inclusion Criteria, Surrogates:
- involved in the care of an eligible patient as the legal next-of-kin
- English-speaking
Exclusion Criteria, Surrogates:
- unable to complete informed consent procedures
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Jumpstart Intervention
|
The intervention has 4 steps: use electronic medical record (EHR) to identify seriously ill, hospitalized patients with no documentation of a goals-of-care (GOC) discussion during their current admission; the enrolled patient or his/her surrogate completes a survey assessing preferences for discussions about GOC, barriers to having such discussions, and current GOC which is used to create a "Jumpstart" form designed to prompt and guide a GOC discussion between the patient or surrogate and the clinicians caring for the patient; use natural language processing/machine learning (NLP/ML) approach to identify GOC discussions or advance directives in the EHR that occurred prior to admission and include this information on the Jumpstart form; and, deliver the Jumpstart form to the primary clinician team.
The patient or surrogate is also provided with a version of the form.
|
|
No Intervention: Usual Inpatient Hospital Care
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Documentation of Goals of Care
Time Frame: At hospital discharge, an average of 2 weeks
|
Presence of documentation of goals of care discussions in the patient's electronic health record during the index hospitalization
|
At hospital discharge, an average of 2 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Ruth Engelberg, PhD, University of Washington
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Endocrine System Diseases
- Cardiovascular Diseases
- Pathologic Processes
- Neoplasms
- Male Urogenital Diseases
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Heart Diseases
- Chronic Disease
- Disease Attributes
- Immune System Diseases
- Respiratory Tract Diseases
- Neoplasms by Histologic Type
- Digestive System Diseases
- Diabetes Mellitus
- Hematologic Diseases
- Liver Diseases
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Leukemia, B-Cell
- Leukemia
- Atherosclerosis
- Arteriosclerosis
- Arterial Occlusive Diseases
- Hepatic Insufficiency
- Heart Failure
- Lung Diseases
- Leukemia, Lymphoid
- Leukemia, Lymphocytic, Chronic, B-Cell
- Vascular Diseases
- Peripheral Arterial Disease
- Renal Insufficiency
- Renal Insufficiency, Chronic
- End Stage Liver Disease
- Liver Failure
- Peripheral Vascular Diseases
- Diabetes Complications
Other Study ID Numbers
Other Study ID Numbers
- STUDY00004821
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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