Advance Care Planning at London Health Sciences Centre

NCT03297320 | Unknown

• 1 other identifier: R-16-299
• Study Type: interventional
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

All patients admitted to London Health Sciences Centre (LHSC) are asked to indicate their preferences for CPR (cardiopulmonary resuscitation) and other life-sustaining treatments that necessitate an Intensive Care Unit (ICU) admission. Complex, high-risk patients at LHSC require multiple admissions to the hospital towards their end-of-life (EOL). Documentation of their resuscitation status should be a part of a broader dialogue with patients around their goals of care (GOC) and advance care planning (ACP), but rarely is this the case. The innovation will involve the use of trained nurse facilitators to have meaningful conversations with patients and their families in an effective way that bridges the gap between resuscitation status, GOC discussions and ACP across the continuum of care.

Conditions

Advance Care Planning

Keywords

Advance Care Planning, End of life, CPR

Outcome Measures

Primary Outcomes (1)

• Incidence of Discordance

  Discordance between patients' prior expressed preferences and those documented in their healthcare record

  2 years

Secondary Outcomes (1)

• Risk factors associated with discordance

  2 years

Study Arms (2)

Team Referrals

ACTIVE COMPARATOR

In-depth conversations about Goals of Care and ACP (the intervention) will be held for the patients referred to the research team by the three healthcare teams in Internal Medicine at London Health Sciences Centre (University Campus)

Other: In-depth conversation about Goals of Care and ACP

Random selection

ACTIVE COMPARATOR

A random selection of patients (not referred to the research team by the healthcare team) in Internal Medicine at London Health Sciences Centre (University Campus) will be selected to have in-depth conversations about Goals of Care and ACP (the intervention)

Other: In-depth conversation about Goals of Care and ACP

Interventions

In-depth conversation about Goals of Care and ACP OTHER

In-depth conversation regarding Goals of Care and ACP by an experienced practitioner

Random selection; Team Referrals

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients admitted to internal medicine teams at or after hospitalization day 2 with:
• Age ≥55 years with ≥1 diagnoses: Chronic lung disease, Coronary artery disease, Congestive heart failure, Cirrhosis, Renal failure, Diabetes, Peripheral vascular disease, Cancer, Dementia (inability with ADLs) or
• If none of these criteria were met, any patient whose death within the next 1 year would not surprise health-care team members.

You may not qualify if:

• Lack of written consent
• Patients who do not speak English; hard of hearing
• Expected to die or be discharged ≤ 24 hours
• Referral to or having an established palliative care plan

Sponsors & Collaborators

• London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's: lead

Study Sites (1)

London Health Sciences Centre

London, Ontario, N6A 5A5, Canada

RECRUITING

MeSH Terms

Conditions

Death

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Ravi Taneja, FRCPC

  Western University, Canada

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Launa Elliott, BSc

CONTACT

519 685-8500; Ravi.Taneja@lhsc.on.ca

Ravi Taneja, FRCPC

CONTACT

519 685-8500; Ravi.Taneja@lhsc.on.ca

Study Design

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

Model Details: Healthcare teams in Internal Medicine at London Health Sciences Centre will be asked if they have any patients that need further goals of care discussions or ACP. A random selection of Internal Medicine patients will also be selected for further indepth conversations related to goals of care discussions or ACP

Study Record Dates

• First Submitted: September 26, 2017
• First Posted: September 29, 2017
• Study Start: January 1, 2017
• Primary Completion: December 31, 2018
• Study Completion: March 31, 2019
• Last Updated: September 29, 2017

Record last verified: 2017-09

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)