Can We Improve the Quality of Care at the End of Life in Israel?

NCT02129283 | Unknown

• 1 other identifier: 0126-14-HMO
• Study Type: interventional
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine whether end-of-life training of ICU professionals leads to improvements in ICU care process, teamwork and family satisfaction.

Conditions

End of Life Process

Keywords

physicians, nurses, ICU, end-of-life, simulation training

Outcome Measures

Primary Outcomes (1)

• Change in ICU care process in an ICU from baseline

  Additional information about the outcome measure- Other parameters for ICU care process include physician or nurse asking about patient preferences, documentation of patient and/or surrogate preferences, documented family conferences, receiving CPR, ventilation, vasopressors or dialysis, deaths preceded by DNRs, limitations of life-sustaining treatments or CPR, time from ICU admission to first discussion about limitations, to DNR and to death and time from first discussion about limitations until death.

  3-6 months and 12 months post-training

Secondary Outcomes (1)

• Change in Family satisfaction in an ICU from baseline

  3-6 months and 12 months post-training

Other Outcomes (1)

• Change in Teamwork in an ICU from baseline

  3-6 months and 12 months post-training

Study Arms (2)

Simulation training

EXPERIMENTAL

End-of-life simulation training of critical care physicians and nurses using standardized patients to improve communication and interpersonal skills.

Behavioral: Simulation training

Control

NO INTERVENTION

No simulation training

Interventions

Simulation training BEHAVIORAL

End-of-life simulation training. The simulation training will include training with standardized patients (actors) using 9 essential skills for communication and interpersonal relationships. The control group will have no training.

Simulation training

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Critical care physicians and nurses working in Israeli ICUs.
• Consent to participate in the study whether they undergo the simulation training or not.

You may not qualify if:

• Physicians and nurses NOT working in Israeli ICUs.
• Refuse to participate in the study.

Sponsors & Collaborators

• Hadassah Medical Organization: lead
• Israel Center for Medical Simulation (MSR): collaborator
• Clalit Health Services: collaborator
• The Samuel Sebba Charitable Trust: collaborator

Study Sites (1)

Hadassah Hebrew University Medical Center

Jerusalem, 91120, Israel

Location

Related Publications (11)

• Meyer EC, Sellers DE, Browning DM, McGuffie K, Solomon MZ, Truog RD. Difficult conversations: improving communication skills and relational abilities in health care. Pediatr Crit Care Med. 2009 May;10(3):352-9. doi: 10.1097/PCC.0b013e3181a3183a.

  PMID: 19325506 BACKGROUND

• Sprung CL, Maia P, Bulow HH, Ricou B, Armaganidis A, Baras M, Wennberg E, Reinhart K, Cohen SL, Fries DR, Nakos G, Thijs LG; Ethicus Study Group. The importance of religious affiliation and culture on end-of-life decisions in European intensive care units. Intensive Care Med. 2007 Oct;33(10):1732-9. doi: 10.1007/s00134-007-0693-0. Epub 2007 Jun 1.

  PMID: 17541550 BACKGROUND

• Azoulay E, Chevret S, Leleu G, Pochard F, Barboteu M, Adrie C, Canoui P, Le Gall JR, Schlemmer B. Half the families of intensive care unit patients experience inadequate communication with physicians. Crit Care Med. 2000 Aug;28(8):3044-9. doi: 10.1097/00003246-200008000-00061.

  PMID: 10966293 BACKGROUND

• Embriaco N, Azoulay E, Barrau K, Kentish N, Pochard F, Loundou A, Papazian L. High level of burnout in intensivists: prevalence and associated factors. Am J Respir Crit Care Med. 2007 Apr 1;175(7):686-92. doi: 10.1164/rccm.200608-1184OC. Epub 2007 Jan 18.

  PMID: 17234905 BACKGROUND

• Wall RJ, Curtis JR, Cooke CR, Engelberg RA. Family satisfaction in the ICU: differences between families of survivors and nonsurvivors. Chest. 2007 Nov;132(5):1425-33. doi: 10.1378/chest.07-0419. Epub 2007 Jun 15.

  PMID: 17573519 BACKGROUND

• Selph RB, Shiang J, Engelberg R, Curtis JR, White DB. Empathy and life support decisions in intensive care units. J Gen Intern Med. 2008 Sep;23(9):1311-7. doi: 10.1007/s11606-008-0643-8.

  PMID: 18574641 BACKGROUND

• Ziv A, Ben-David S, Ziv M. Simulation based medical education: an opportunity to learn from errors. Med Teach. 2005 May;27(3):193-9. doi: 10.1080/01421590500126718.

  PMID: 16011941 BACKGROUND

• McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010 Jan;44(1):50-63. doi: 10.1111/j.1365-2923.2009.03547.x.

  PMID: 20078756 BACKGROUND

• McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med. 2011 Jun;86(6):706-11. doi: 10.1097/ACM.0b013e318217e119.

  PMID: 21512370 BACKGROUND

• Alexander SC, Keitz SA, Sloane R, Tulsky JA. A controlled trial of a short course to improve residents' communication with patients at the end of life. Acad Med. 2006 Nov;81(11):1008-12. doi: 10.1097/01.ACM.0000242580.83851.ad.

  PMID: 17065871 BACKGROUND

• Ziv A, Erez D, Munz Y, Vardi A, Barsuk D, Levine I, Benita S, Rubin O, Berkenstadt H. The Israel Center for Medical Simulation: a paradigm for cultural change in medical education. Acad Med. 2006 Dec;81(12):1091-7. doi: 10.1097/01.ACM.0000246756.55626.1b.

  PMID: 17122476 BACKGROUND

MeSH Terms

Conditions

Death

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Charles L Sprung, MD

  Hadassah Medical Organization

  STUDY CHAIR

• Amiram Lev, MD

  Afula Hospital, Afula, Israel

  PRINCIPAL INVESTIGATOR

• Moti Klein, MD

  Soroka Hospital, Beer Sheva

  PRINCIPAL INVESTIGATOR

• Nimrod Adi

  Kaplan Hospital, Rechovot, Israel

  PRINCIPAL INVESTIGATOR

• Pierre Singer, MD

  Beilinson Hospital, Petach Tikva,Israel

  PRINCIPAL INVESTIGATOR

• Arik Eden, MD

  Carmel Hospital, Haifa, Israel

  PRINCIPAL INVESTIGATOR

• Nissim Yifrach, MD

  Meir Hospital, Kfar Saba, Israel

  PRINCIPAL INVESTIGATOR

• Shaul Lev, MD

  Sharon Hospital, Herzilia, Israel

  PRINCIPAL INVESTIGATOR

• Amitai Ziv, MD

  Israel Center for Medical Simulation (MSR), The Sheba Medical Center, Tel Hashomer , Ramat Gan, Israel

  PRINCIPAL INVESTIGATOR

• Yigal Shoshan, MD

  Hadassah Medical Organization

  PRINCIPAL INVESTIGATOR

• Mayer Brezis, MD

  Hadassah Medical Organization

  PRINCIPAL INVESTIGATOR

• Eyal Jacobson, MD

  Ministry of Health, Israel

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Charles L Sprung, MD

CONTACT

972 2 677 8060; charles.sprung@ekmd.huji.ac.il

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 28, 2014
• First Posted: May 2, 2014
• Study Start: May 1, 2014
• Primary Completion: May 1, 2016
• Study Completion: May 1, 2017
• Last Updated: May 2, 2014

Record last verified: 2014-04

Locations

IL (1)