Project to Improve Communication About Serious Illness - Pilot Study

This two-year pilot study will test whether a one-page "Jumpstart Form" will affect goals-of-care discussions in the hospital. This form will be provided to clinicians and will include patient-specific information about preferences for goals-of-care communication and for care, as well as tips to improve this communication. Jumpstart forms will also be provided to patients or, if they are unable to communicate, their surrogates/family members. The information on the form will be obtained from questionnaires. The form is tailored to help patients and surrogates talk with clinicians about goals of care. This study is based on a successful application of Jumpstart Form in the outpatient clinic setting.

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Key information

Conditions

Malignant Neoplasm Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Chronic Disease Congestive Heart Failure Dementia Diabetes Complications Diabetes Mellitus Digestive System Diseases Disease Attributes End Stage Liver Disease Endocrine System Diseases Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Frail Elderly Heart Diseases Heart Failure Hematologic Diseases Hemic and Lymphatic Diseases Hepatic Insufficiency Immune System Diseases Immunoproliferative Disorders Kidney Diseases Leukemia Leukemia, B-Cell Leukemia, Lymphocytic, Chronic, B-Cell Leukemia, Lymphoid Liver Diseases Liver Failure Liver Failures, Chronic Lung Disease Chronic Lymphatic Diseases Lymphoproliferative Disorders Male Urogenital Diseases Mental Disorders Neoplasms Neoplasms by Histologic Type Nervous System Diseases Neurocognitive Disorders Pathologic Processes Pathological Conditions, Signs and Symptoms Peripheral Vascular Disease Peripheral Vascular Diseases Renal Insufficiency Renal Insufficiency, Chronic Urogenital Diseases Urologic Diseases Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Harborview Medical Center, Seattle, Washington, United States

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

, Patients: meeting criteria for serious illness (encompassing multiple acute and chronic illnesses) including:

those used by the Dartmouth Atlas to study end-of-life care in the US: malignant cancer/leukemia, chronic pulmonary disease, coronary artery disease, congestive heart failure, chronic liver disease, chronic renal disease, dementia, diabetes with end-organ damage, and peripheral vascular disease.
patients over age 65 with markers of frailty: albumin level <3.0 within 48 hours of admission and weight loss of ≥10 pounds in the past year.
hospitalized patients over age 80.
English-speaking

Exclusion criteria

, Patients:

unable to complete informed consent procedures and do not have a legal next of kin
restricted information status (e.g. prisoners)
pregnant

Inclusion criteria

, Surrogates:

involved in the care of an eligible patient as the legal next-of-kin
English-speaking

Exclusion criteria

, Surrogates:

unable to complete informed consent procedures

Treatment and study plan

Jumpstart Intervention

Behavioral

The intervention has 4 steps: use electronic medical record (EHR) to identify seriously ill, hospitalized patients with no documentation of a goals-of-care (GOC) discussion during their current admission; the enrolled patient or his/her surrogate completes a survey assessing preferences for discussions about GOC, barriers to having such discussions, and current GOC which is used to create a "Jumpstart" form designed to prompt and guide a GOC discussion between the patient or surrogate and the clinicians caring for the patient; use natural language processing/machine learning (NLP/ML) approach to identify GOC discussions or advance directives in the EHR that occurred prior to admission and include this information on the Jumpstart form; and, deliver the Jumpstart form to the primary clinician team. The patient or surrogate is also provided with a version of the form.

Primary outcomes

Documentation of Goals of Care

Time frame: At hospital discharge, an average of 2 weeks

Presence of documentation of goals of care discussions in the patient's electronic health record during the index hospitalization

Sponsors and collaborators

Lead sponsor

University of Washington

Other

Registry information

Official study title

Using the Electronic Health Record to Identify and Promote Goals-of-Care Communication

Acronym: PICSI-P

Important dates

Study start: 2018
Primary completion: 2020
Study completion: 2020
First posted: Nov 19, 2018
Registry last updated: Aug 22, 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.

Published trials that share one or more normalized conditions with this study.

Completed