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EFFECTIVENESS: Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning by Hospitalists

11. februar 2022 opdateret af: Amber Barnato, Dartmouth-Hitchcock Medical Center

Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning Conversations by Hospitalists With Older Adults

Hopewell Hospitalist is a theory-based adventure video game designed to increase the likelihood that a physician will engage in an advance care planning (ACP) conversation with a patient over the age of 65. Drawing on the theory of narrative engagement, players assume the persona of a hospitalist physician and navigate a series of clinical encounters with seriously-ill patients over the age of 65. Players experience the consequences of having (or not having) ACP conversations in a timely fashion. The planned study is a crossover phase III trial testing the effectiveness of providing physicians with a link to a free version of Hopewell Hospitalist as a means for increasing ACP rates measured by ACP billing frequency.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

1261

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • New Hampshire
      • Lebanon, New Hampshire, Forenede Stater, 03766
        • Dartmouth Hitchcock Medical Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Beskrivelse

Hospitalist Inclusion Criteria:

  • Employed by Sound
  • Not previously included in the Efficacy Trial Arm of the study.

Hospitalist Exclusion Criteria:

  • Not employed by Sound
  • Does not provide informed consent
  • Previously included in the Efficacy Trial Arm of the study.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Sundhedstjenesteforskning
  • Tildeling: Randomiseret
  • Interventionel model: Sekventiel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Ingen indgriben: Control: Usual Care
The control arm occurs prior to receipt of the video game intervention and reflects usual care. Each hospitalist 'crosses over' from control to intervention at a single time point.
Eksperimentel: Video Game Intervention
Each hospitalist 'crosses over' from control to intervention at a single time point by receiving a link to the Hopewell Hospitalist game via email and logging in to play the video game.
Adfærdsmæssigt: Hopewell Hospitalist videospil
Hopewell Hospitalist er et skræddersyet teoribaseret eventyrvideospil, der bruger narrativt engagement til at uddanne lægespillere i forudgående plejeplanlægning for at øge lægers sandsynlighed for at deltage i og fakturere for AVS-samtaler.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of Billed Advance Care Planning
Tidsramme: 6 months (3 months pre and 3 months post intervention)
Change in physician advance care planning billing for patients over the age of 65 in the three months before and after the roll-out of the video game intervention at their hospital. Advance care planning billing is defined as the presence/absence of ACP charges (Medicare billing codes 99497 or 99498) during a physician's patient's hospitalization.
6 months (3 months pre and 3 months post intervention)
Merit-based Incentive Payment System Advance Care Planning Quality Score
Tidsramme: 6 months (3 months pre and 3 months post intervention)
Change in the Merit-based Incentive Payment System (MIPS) self-report measure of advance care planning by enrolled hospitalists (MiPS-ACP quality score). The MiPS-ACP quality score is the percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan. The quality score ranges from 0-100%, with higher scores indicating that a greater proportion of patients with an advance care plan documented in the medical record.
6 months (3 months pre and 3 months post intervention)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Hospitalist-Managed Patient In-Hospital Mortality Rate
Tidsramme: 6 months (3 months pre and 3 months post intervention)
In-hospital mortality rate for patients managed by enrolled hospitalists.
6 months (3 months pre and 3 months post intervention)
Hospitalist-Managed Patient 90-Day Mortality Rate
Tidsramme: 6 months (3 months pre and 3 months post intervention)
90-day mortality rate for patients managed by enrolled hospitalists.
6 months (3 months pre and 3 months post intervention)
Sum of Resources Utilized by Hospitalist-Managed Patients
Tidsramme: 6 months (3 months pre and 3 months post intervention)
Combined sum of resources utilized by patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention). It is a composite measure including: admission to ICU, receipt of life-sustaining treatment(s) including mechanical ventilation, placement of tracheostomy, insertion of gastric feeding tube, new onset dialysis. This measure ranges from 0 to 5, where higher scores indicate greater utilization of resources during the index hospitalization.
6 months (3 months pre and 3 months post intervention)
Incidence of Hospitalist-Managed Patient Admission to ICU
Tidsramme: 6 months (3 months pre and 3 months post intervention)
Incidence of admission to ICU for patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).
6 months (3 months pre and 3 months post intervention)
Incidence of Hospitalist-Managed Patient Mechanical Ventilation
Tidsramme: 6 months (3 months pre and 3 months post intervention)
Incidence of mechanical ventilation of patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).
6 months (3 months pre and 3 months post intervention)
Incidence of Hospitalist-Managed Patient Receipt of Life-Sustaining Treatment(s)
Tidsramme: 6 months (3 months pre and 3 months post intervention)
Incidence of placement of tracheostomy, insertion of gastric feeding tube, new onset dialysis for patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).
6 months (3 months pre and 3 months post intervention)
Hospitalist-Managed Patient Length of Stay
Tidsramme: 6 months (3 months pre and 3 months post intervention)
Total days between admission and discharge for patients managed by enrolled hospitalists.
6 months (3 months pre and 3 months post intervention)
Hospitalist-Managed Patient Disposition Status Type
Tidsramme: 6 months (3 months pre and 3 months post intervention)
Type of status upon discharge of patients managed by enrolled hospitalists (e.g., discharged to home, to skilled nursing, to hospice, deceased, etc.).
6 months (3 months pre and 3 months post intervention)
Hospitalist-Managed Patient 90-Day Episode-Based Spending
Tidsramme: 6 months (3 months pre and 3 months post intervention)
Amount of total Medicare payments between index admission and 90-days for patients managed by enrolled hospitalists.
6 months (3 months pre and 3 months post intervention)

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Hopewell Hospitalist - Apple App Store and Google Analytics
Tidsramme: 3 months
Number of unique downloads for the HH game will be provided by the Apple App store. Using Google Analytics we will be able to discern time spent playing the game for each individual hospitalist using their unique log-in passphrase.
3 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Dartmouth-Hitchcock Medical Center

Samarbejdspartnere

National Institute on Aging (NIA)
Sound Physicians

Efterforskere

  • Ledende efterforsker: Amber Barnato, MD, MPH, MS, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine�

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

15. juli 2021

Primær færdiggørelse (Faktiske)

13. august 2021

Studieafslutning (Faktiske)

13. august 2021

Datoer for studieregistrering

Først indsendt

6. maj 2021

Først indsendt, der opfyldte QC-kriterier

6. maj 2021

Først opslået (Faktiske)

11. maj 2021

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

25. februar 2022

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

11. februar 2022

Sidst verificeret

1. februar 2022

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • STUDY00031186 - B
  • P01AG019783 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

We will share de-identified participant data and supporting information with other researchers upon request to the PI.

IPD-delingstidsramme

Upon publication of the planned manuscripts. Data will be retained through February 2028.

IPD-delingsadgangskriterier

Data will require completion of a data use agreement with Dartmouth.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • ANALYTIC_CODE
  • CSR

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