Disseminating a Digital ACP Platform (Our Care Wishes) to Hospitalized Patients

NCT03727685 | Completed

• 1 other identifier: 831901
• Study Type: interventional
• Target: 16,020
• Locations: 1 country
• Sites: 1

Brief Summary

Penn Medicine has created a novel, online, evidence-based advance care planning (ACP) platform through its Center for Health Care Innovation. The platform is called "Our Care Wishes" and utilizes a 'shopping-cart' approach to ACP, allowing users to name surrogate decision makers, make choices about quality of life and medical treatments, outline medical wishes and organ donation, and share preferences for their end of life experience. Our Care Wishes then creates an easy to read, updatable ACP document that can be electronically shared with loved ones and uploaded to a patient's electronic medical record in PennChart. It is believed that this platform may help to overcome engagement and infrastructure barriers previously identified in the literature regarding the completion of ACP documents. The intervention will consist of multi-channel information dissemination regarding Our Care Wishes to Hospital of the University of Pennsylvania patients admitted through two locations (the Emergency Department, Silverstein 1 Admission Office) and outpatients who are seen in Pre-Admission Testing (PAT). All patients visiting these two locations during the intervention phase will receive a paper handout with information regarding Our Care Wishes included in their customary admission folder packet. The registration representative (RR) at these three locations will provide a brief explanation of the site as they check the patients in, as well send the patients a direct link to the site for non-ED admits via email and text message.

Conditions

Hospitalism

Keywords

Advance care planning

Outcome Measures

Primary Outcomes (1)

• New Presence of ACP

  Presence of an uploaded advance care planning document that shares any care wishes or preferences (beyond simply naming a surrogate)

  within two months of the index visit

Study Arms (2)

Usual care

NO INTERVENTION

Patients admitted to the hospital will not receive information about Our Care Wishes.

Intervention: Our Care Wishes

ACTIVE COMPARATOR

Patients admitted to the hospital during the intervention phase will receive information from registration representatives regarding Our Care Wishes.

Behavioral: Our Care Wishes

Interventions

Our Care Wishes BEHAVIORAL

A flyer describing the Our Care Wishes platform will be added to the back pocket of admission packets for patients being admitted via the Silverstein 1 Admission Office and the Emergency Department and for patients being seen in the Pre Admission Testing office. Registration reps in these locations will inform all patients seen that Penn has created a free, online resource called Our Care Wishes to help patients with Advance Care Planning and ask if they would like to be sent a link to Our Care Wishes by email or text. For those patients who respond affirmatively, the rep will then complete the necessary fields to refer on www.ourcarewishes.org/refer.

Intervention: Our Care Wishes

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult admitted at the University of Pennsylvania via two locations: the Emergency Department, Silverstein 1 admission office;
• Patients that are seen in the Pre-Admission Testing (PAT) clinic
• Patients must speak English fluently

You may not qualify if:

• Maternity patients

Sponsors & Collaborators

• University of Pennsylvania: lead

Study Sites (1)

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Related Links

• Main intervention

Study Officials

• Scott D Halpern, Ph.D, MD

  University of Pennsylvania

  PRINCIPAL INVESTIGATOR

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: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Medicine

Model Details: The design is a stepped-wedge cluster design in which specific areas of the hospital will adopt the intervention, in sequence. All areas of the hospital will begin in the control phase. 12 weeks into the study period, the first "wedge" or area of the hospital will adopt the Our Care Wishes intervention, 4 weeks after, the next wedge will switch the control phase, the final wedge will adopt the intervention after that.

Study Record Dates

• First Submitted: October 30, 2018
• First Posted: November 1, 2018
• Study Start: February 25, 2019
• Primary Completion: December 2, 2019
• Study Completion: May 1, 2022
• Last Updated: June 15, 2023

Record last verified: 2023-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)