EFFECTIVENESS: Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning by Hospitalists
2022年2月11日 更新者：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.
調査の概要
研究の種類
介入
入学 (実際)
1261
段階
- 適用できない
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
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New Hampshire
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Lebanon、New Hampshire、アメリカ、03766
- Dartmouth Hitchcock Medical Center
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
はい
受講資格のある性別
全て
説明
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.
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：ヘルスサービス研究
- 割り当て：ランダム化
- 介入モデル：順次割り当て
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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介入なし：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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実験的：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 は、カスタマイズされた理論ベースのアドベンチャー ビデオ ゲームで、ナラティブ エンゲージメントを使用して医師のプレイヤーに事前治療計画について教育し、医師が ACP の会話に参加して料金を請求する可能性を高めます。
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Incidence of Billed Advance Care Planning
時間枠：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
時間枠：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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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Hospitalist-Managed Patient In-Hospital Mortality Rate
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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)
時間枠：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
時間枠：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
時間枠：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
時間枠：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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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Hopewell Hospitalist - Apple App Store and Google Analytics
時間枠：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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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
捜査官
- 主任研究者：Amber Barnato, MD, MPH, MS、Dartmouth-Hitchcock Medical Center and Geisel School of Medicine�
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
2021年7月15日
一次修了 (実際)
2021年8月13日
研究の完了 (実際)
2021年8月13日
試験登録日
最初に提出
2021年5月6日
QC基準を満たした最初の提出物
2021年5月6日
最初の投稿 (実際)
2021年5月11日
学習記録の更新
投稿された最後の更新 (実際)
2022年2月25日
QC基準を満たした最後の更新が送信されました
2022年2月11日
最終確認日
2022年2月1日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- STUDY00031186 - B
- P01AG019783 (米国 NIH グラント/契約)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
はい
IPD プランの説明
We will share de-identified participant data and supporting information with other researchers upon request to the PI.
IPD 共有時間枠
Upon publication of the planned manuscripts.
Data will be retained through February 2028.
IPD 共有アクセス基準
Data will require completion of a data use agreement with Dartmouth.
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
いいえ
米国FDA規制機器製品の研究
いいえ
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
アドバンスケアプランニングの臨床試験
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