Advance Care Planning Notifications in General Inpatient Medicine

This study will evaluate the impact of and response by physicians on Hospital Medicine/General Internal Medicine service to a notification identifying seriously ill patients at high risk of death within 30 days as well as within 6 months in a cluster randomized control trial.

Study Overview

• Status: Completed
• Conditions: Advance Care Planning
• Intervention / Treatment: Other: Notification system

• Study Type: Interventional
• Enrollment (Actual): 73
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Durham, North Carolina, United States, 27705
      • Duke University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• At least 18 years of age
• Attending Physician on the Hospital Medicine or General Internal Medicine Service at Duke University Hospital

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention	Other: Notification system; Email and page notification sent to clinicians for patients at high-risk of mortality in 30 days and 6 months
No Intervention: Control

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Proportion of advance care planning notes as measured by electronic health record data during hospitalization	Up to 30 days

Secondary Outcome Measures

Outcome Measure	Time Frame
Proportion of advance care planning codes billed as measured by electronic health record data	Up to 30 days
Proportion of Palliative Care Consults (Inpatient/Outpatient) as measured by electronic health record data	Up to 90 days
Proportion of patients discharged to hospice as measured by electronic health record data	Up to 30 days
Proportion of patients' code status changed to Do-Not-Resuscitate as measured by electronic health record data	Up to 30 days
Proportion of patient deaths as measured by electronic health record data	Up to 14 days
Proportion of patient deaths as measured by electronic health record data	Up to 30 days
Proportion of patient deaths as measured by electronic health record data	Up to 6 months
Proportion of patient re-admitted to the hospital as measured by electronic health record data	Up to 30 days
Proportion of patient re-admitted to the hospital as measured by electronic health record data	Up to 6 months
Proportion of advance care planning paperwork filed as measured by electronic health record data	Up to 30 days

Collaborators and Investigators

• Sponsor: Duke University
• Investigators: Principal Investigator: David Casarett, MD, Duke University; Principal Investigator: Jessica Ma, MD, Duke University

Study record dates

Study Major Dates

• Study Start (Actual): February 15, 2021
• Primary Completion (Actual): December 31, 2022
• Study Completion (Actual): June 30, 2023

Study Registration Dates

• First Submitted: February 12, 2021
• First Submitted That Met QC Criteria: February 12, 2021
• First Posted (Actual): February 16, 2021

Study Record Updates

• Last Update Posted (Actual): October 17, 2024
• Last Update Submitted That Met QC Criteria: October 15, 2024
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Other Study ID Numbers: Pro00107026

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No