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Completed

NCT Number: NCT04296136

Quality Improvement Project for Advance Care Planning Tool in Hospital Medicine

Hospitalized patients and their families are often unprepared regarding end-of-life care. Even patients with high risk of mortality within the index admission or 30 days after admission often do not have clearly defined goals of care. This lack of clarity can create difficult scenarios for patients, their families, and care providers. Lack of communication and documentation of these goals can lead to unnecessary tests, procedures, and readmissions. By creating advanced care planning education for the hospital medicine department, a standardized note template, and EMR utilization for storage and reference of patient's goals of care documentation we aim to facilitate the conveyance of patient's wishes/preferences across different care providers and across separate encounters within the healthcare system. For this study, we will use a pre-post study design to evaluate the implementation of this quality improvement intervention.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Duke University

Durham, North Carolina, 27705, United States

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • All patients admitted to the inpatient medicine service with high risk of mortality.

Exclusion criteria

  • Involuntary commitment during the index admission

Treatment and study plan

Advance Care Planning Discussion

Other

Goals of care discussion with patient, documentation with electronic health record note and advance care planning billing. This will also include: pharmacy review of medications, case management review, and coding specialist review.

Primary outcomes

  1. Proportion of patients who have advanced care planning notes completed during the admission

    Time frame: Hospital admission, up to 7 days

    As measured by medical record review (Pre-implementation)

  2. Proportion of patients who have advanced care planning notes completed during the admission

    Time frame: Hospital admission, up to 7 days

    As measured by medical record review (Post-implementation)

Secondary outcomes

  1. Proportion of patient who have documentation utilizing the electronic health record dotphrase note template

    Time frame: Hospital admission, up to 7 days

    As measured by medical record review (Pre-implementation)

  2. Proportion of patient who have documentation utilizing the electronic health record dotphrase note template

    Time frame: Hospital admission, up to 7 days

    As measured by medical record review (Post-implementation)

  3. Proportion of patients who are billed for advanced care planning

    Time frame: Hospital admission, up to 7 days

    As measured by medical record review (Pre-implementation)

  4. Proportion of patients who are billed for advanced care planning

    Time frame: Hospital admission, up to 7 days

    As measured by medical record review (Post-implementation)

  5. Proportion of patients who receive palliative care consults

    Time frame: Hospital admission, up to 7 days

    As measured by medical record review (Pre-implementation)

  6. Proportion of patients who receive palliative care consults

    Time frame: Hospital admission, up to 7 days

    As measured by medical record review (Post-implementation)

  7. Proportion of patients who are discharged to hospice

    Time frame: Hospital discharge, up to 7 days

    As measured by medical record review (Pre-implementation)

  8. Proportion of patients who are discharged to hospice

    Time frame: Hospital discharge, up to 7 days

    As measured by medical record review (Post-implementation)

  9. Proportion of patients who have an appointment to the palliative care clinic

    Time frame: Up to 1 month

    As measured by medical record review (Pre-implementation)

  10. Proportion of patients who have an appointment to the palliative care clinic

    Time frame: Up to 1 month

    As measured by medical record review (Post-implementation)

Sponsors and collaborators

Lead sponsor

Duke University

Other

Registry information

Official study title

Quality Improvement Project: Assessing the Use of Advanced Care Planning Documentation for Patients at High Risk of 30-day Mortality on Hospital Medicine Services

Important dates

Study start
2019
Primary completion
2021
Study completion
2022
First posted
Mar 5, 2020
Registry last updated
May 18, 2022

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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