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Active, Not Recruiting

NCT Number: NCT03935997

Implementing, Evaluating, and Scaling Up of the Strengthening a Palliative Approach in Long Term Care (SPA-LTC) Program

This study will evaluate the implementation of the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) program using a cross-jurisdictional, effectiveness-implementation type II hybrid design (dual testing of clinical and implementation interventions) to assess the implementation (feasibility, fidelity, reach, sustainability) and effectiveness (family satisfaction, staff knowledge and confidence implementing a palliative approach to care, hospital use).

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Frail Elderly Syndrome

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Manitoba, Winnipeg, Manitoba, Canada

Loading trial locations.

About this study

The SPA-LTC program has been developed and refined through prior participatory action based studies.

Evidence-based components of the program include:

Palliative Champion Teams; Palliative Care Education, including illness-trajectory pamphlets for staff and family members; Comfort Care Rounds with staff; Prognostic Tools to trigger end-of-life discussions; Palliative Care Conferences; Bereavement Pamphlets for families; and Post-Bereavement Follow-Up for families, and staff

The goal is to implement and assess this program across three provinces in Canada (Ontario, Saskatchewan, Manitoba). The investigators will use the findings to revise the program and inform the scaling up of the program across diverse settings and provinces.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • English-speaking LTC residents with a score of 50% or less on the Palliative Performance Scale.

Exclusion criteria

  • Non-English speaking LTC residents
  • residents with a score of more than 50% on the Palliative Performance Scale.

Treatment and study plan

Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) Program

Other

Our team will work with long-term care homes in the study to implement the Strengthening a Palliative Approach in Long Term Care (SPA-LTC) which consists of the following core, evidence-informed components:

Palliative Champion Teams (to provide leadership and support implementation); Palliative Care Education (including illness trajectory pamphlets); Comfort Care Rounds with staff (for capacity building and reflection); Prognostic Tools to trigger end-of-life discussions; Palliative Care Conferences with families and residents; Bereavement Pamphlets; and Post-Bereavement Follow-Up for families, and staff.

Primary outcomes

  1. Number of Emergency Department Visits in the Resident's Last Year of Life

    Time frame: All residents in the home who died one year prior to the implementation and one year prior to the date of death for all residents in the home who die during the study intervention period.

Secondary outcomes

  1. Family Perceptions of End of Life Care

    Time frame: Survey completed at enrolment into the study; survey completed 2 months after the Family Care Conference or 1 month after the end of the intervention period if no Family Care Conference occurred.

    Survey

  2. Family Experiences with End of Life Care

    Time frame: Interview completed at enrolment into the study; survey completed 2 months after the Family Care Conference or 1 month after the end of the intervention period if no Family Care Conference occurred.

    Interview

  3. Staff Knowledge about a Palliative Approach to Care

    Time frame: All staff in all participating long-term care homes will complete a staff survey at 2 points in the study: at the beginning and the end of the intervention

    Survey

  4. Number of Hospital Transfers per Resident

    Time frame: Chart audit at start of the trial to capture data on residents who died in the year prior to the trial. Chart audits also during the transition phase prior to Steps 2 and 3; and one month after the intervention period for the trial ends.

    Chart data at each study site will be audited to capture data on the number of hospital transfers in the last year of life for residents who died 1 year before the trial or who die during the trial.

  5. Number of Hospital Deaths during the trial

    Time frame: Chart audit at start of the trial to capture data on residents who died in the year prior to the trial. Chart audits also during the transition phase prior to Steps 2 and 3; and one month after the intervention period for the trial ends.

    Chart data at each study site will be audited to capture data on the number of hospital deaths in the year prior to the trial and during the trial.

    Chart data at each study site will be audited to capture data on the number of hospital transfers in the residents last year of life.

  6. Bereaved Family Satisfaction with End of Life Care

    Time frame: 6 weeks to 2 months after the resident's death

    Qualitative interview with family members whose loved one died during the trial.

  7. Resident Satisfaction with End of Life Care

    Time frame: At the time of enrolment and 2 months after the Family Care Conference or 1 month after the intervention period if no Family Care Conference occurred.

    Qualitative interview with residents who are enrolled in the trial

Other outcomes

  1. Fidelity of the Intervention

    Time frame: Checklist completed weekly during the intervention period for up to 160 weeks.

    Checklist

Sponsors and collaborators

Lead sponsor

McMaster University

Other

Collaborators

  • Alberta Health services
  • Canadian Hospice Palliative Care Association
  • Canadian Virtual Hospice
  • Hospice Palliative Care Ontario
  • Interlake-Eastern Regional Health Authority
  • Saskatchewan Health Authority - Regina Area

Registry information

Important dates

Study start
2022
Primary completion
2025
Study completion
2026
First posted
May 2, 2019
Registry last updated
Sep 25, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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