EFFECTIVENESS: Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning by Hospitalists
11 février 2022 mis à jour par: 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.
Aperçu de l'étude
Statut
Résilié
Les conditions
Intervention / Traitement
Type d'étude
Interventionnel
Inscription (Réel)
1261
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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New Hampshire
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Lebanon, New Hampshire, États-Unis, 03766
- Dartmouth Hitchcock Medical Center
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
- Enfant
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Oui
Sexes éligibles pour l'étude
Tout
La description
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.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Recherche sur les services de santé
- Répartition: Randomisé
- Modèle interventionnel: Affectation séquentielle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Aucune intervention: 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.
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Expérimental: 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.
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Hopewell Hospitalist est un jeu vidéo d'aventure personnalisé basé sur la théorie qui utilise l'engagement narratif pour éduquer les joueurs médecins sur la planification préalable des soins afin d'augmenter la probabilité qu'ils s'engagent dans des conversations sur les PPS et les facturent.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Incidence of Billed Advance Care Planning
Délai: 6 months (3 months pre and 3 months post intervention)
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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.
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6 months (3 months pre and 3 months post intervention)
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Merit-based Incentive Payment System Advance Care Planning Quality Score
Délai: 6 months (3 months pre and 3 months post intervention)
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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.
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6 months (3 months pre and 3 months post intervention)
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Hospitalist-Managed Patient In-Hospital Mortality Rate
Délai: 6 months (3 months pre and 3 months post intervention)
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In-hospital mortality rate for patients managed by enrolled hospitalists.
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6 months (3 months pre and 3 months post intervention)
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Hospitalist-Managed Patient 90-Day Mortality Rate
Délai: 6 months (3 months pre and 3 months post intervention)
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90-day mortality rate for patients managed by enrolled hospitalists.
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6 months (3 months pre and 3 months post intervention)
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Sum of Resources Utilized by Hospitalist-Managed Patients
Délai: 6 months (3 months pre and 3 months post intervention)
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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.
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6 months (3 months pre and 3 months post intervention)
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Incidence of Hospitalist-Managed Patient Admission to ICU
Délai: 6 months (3 months pre and 3 months post intervention)
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Incidence of admission to ICU for patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).
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6 months (3 months pre and 3 months post intervention)
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Incidence of Hospitalist-Managed Patient Mechanical Ventilation
Délai: 6 months (3 months pre and 3 months post intervention)
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Incidence of mechanical ventilation of patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).
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6 months (3 months pre and 3 months post intervention)
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Incidence of Hospitalist-Managed Patient Receipt of Life-Sustaining Treatment(s)
Délai: 6 months (3 months pre and 3 months post intervention)
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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).
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6 months (3 months pre and 3 months post intervention)
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Hospitalist-Managed Patient Length of Stay
Délai: 6 months (3 months pre and 3 months post intervention)
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Total days between admission and discharge for patients managed by enrolled hospitalists.
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6 months (3 months pre and 3 months post intervention)
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Hospitalist-Managed Patient Disposition Status Type
Délai: 6 months (3 months pre and 3 months post intervention)
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Type of status upon discharge of patients managed by enrolled hospitalists (e.g., discharged to home, to skilled nursing, to hospice, deceased, etc.).
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6 months (3 months pre and 3 months post intervention)
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Hospitalist-Managed Patient 90-Day Episode-Based Spending
Délai: 6 months (3 months pre and 3 months post intervention)
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Amount of total Medicare payments between index admission and 90-days for patients managed by enrolled hospitalists.
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6 months (3 months pre and 3 months post intervention)
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Hopewell Hospitalist - Apple App Store and Google Analytics
Délai: 3 months
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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.
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3 months
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Amber Barnato, MD, MPH, MS, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine�
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
15 juillet 2021
Achèvement primaire (Réel)
13 août 2021
Achèvement de l'étude (Réel)
13 août 2021
Dates d'inscription aux études
Première soumission
6 mai 2021
Première soumission répondant aux critères de contrôle qualité
6 mai 2021
Première publication (Réel)
11 mai 2021
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
25 février 2022
Dernière mise à jour soumise répondant aux critères de contrôle qualité
11 février 2022
Dernière vérification
1 février 2022
Plus d'information
Termes liés à cette étude
Autres numéros d'identification d'étude
- STUDY00031186 - B
- P01AG019783 (Subvention/contrat des NIH des États-Unis)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
OUI
Description du régime IPD
We will share de-identified participant data and supporting information with other researchers upon request to the PI.
Délai de partage IPD
Upon publication of the planned manuscripts.
Data will be retained through February 2028.
Critères d'accès au partage IPD
Data will require completion of a data use agreement with Dartmouth.
Type d'informations de prise en charge du partage d'IPD
- PROTOCOLE D'ÉTUDE
- SÈVE
- CIF
- ANALYTIC_CODE
- RSE
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .