Project to Improve Communication About Serious Illness - Pilot Study
PICSI-P
Using the Electronic Health Record to Identify and Promote Goals-of-Care Communication
1 other identifier
interventional
150
1 country
2
Brief Summary
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.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jul 2018
Typical duration for not_applicable
2 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
Study Start
First participant enrolled
July 1, 2018
CompletedFirst Submitted
Initial submission to the registry
November 9, 2018
CompletedFirst Posted
Study publicly available on registry
November 19, 2018
CompletedPrimary Completion
Last participant's last visit for primary outcome
June 30, 2020
CompletedStudy Completion
Last participant's last visit for all outcomes
June 30, 2020
CompletedResults Posted
Study results publicly available
August 22, 2025
CompletedAugust 22, 2025
August 1, 2025
2 years
November 9, 2018
July 17, 2025
August 6, 2025
Conditions
Outcome Measures
Primary Outcomes (1)
Documentation of Goals of Care
Presence of documentation of goals of care discussions in the patient's electronic health record during the index hospitalization
At hospital discharge, an average of 2 weeks
Study Arms (2)
Jumpstart Intervention
EXPERIMENTALUsual Inpatient Hospital Care
NO INTERVENTIONInterventions
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.
Eligibility Criteria
You may qualify if:
- 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
You may not qualify if:
- unable to complete informed consent procedures and do not have a legal next of kin
- restricted information status (e.g. prisoners)
- pregnant
- involved in the care of an eligible patient as the legal next-of-kin
- English-speaking
- unable to complete informed consent procedures
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (2)
Harborview Medical Center
Seattle, Washington, 98104, United States
University of Washington Medical Center
Seattle, Washington, 98195, United States
Related Publications (1)
Lee RY, Kross EK, Downey L, Paul SR, Heywood J, Nielsen EL, Okimoto K, Brumback LC, Merel SE, Engelberg RA, Curtis JR. Efficacy of a Communication-Priming Intervention on Documented Goals-of-Care Discussions in Hospitalized Patients With Serious Illness: A Randomized Clinical Trial. JAMA Netw Open. 2022 Apr 1;5(4):e225088. doi: 10.1001/jamanetworkopen.2022.5088.
PMID: 35363271DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Results Point of Contact
- Title
- Program Coordinator (Elizabeth Nielsen)
- Organization
- University of Washington
Study Officials
- PRINCIPAL INVESTIGATOR
Ruth Engelberg, PhD
University of Washington
Publication Agreements
- PI is Sponsor Employee
- Yes
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Purpose
- SUPPORTIVE CARE
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- ResearchProfessor, Department of Medicine, SOM: Department of Medicine: Pulmonary, Critical Care and Sleep Medicine
Study Record Dates
First Submitted
November 9, 2018
First Posted
November 19, 2018
Study Start
July 1, 2018
Primary Completion
June 30, 2020
Study Completion
June 30, 2020
Last Updated
August 22, 2025
Results First Posted
August 22, 2025
Record last verified: 2025-08
Data Sharing
- IPD Sharing
- Will not share