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This is a two-armed, parallel-design, pre-/post-intervention assessment study. The investigators will conduct a randomized controlled trial for ED GOAL on a cohort of 120 older adults with serious illness to collect patient-centered outcomes and determine preliminary efficacy on increasing advance care planning engagement (self-reported and/or in the electronic medical record) one month after leaving the emergency department. The investigators will also conduct qualitative interviews with participants of ED GOAL.
ED GOAL, a 6-minute motivational interview conducted in the emergency department (ED), which engages participants to address advance care planning (ACP) conversations with their outpatient clinicians and avoids a time-consuming, sensitive conversation in the time-pressured ED environment. This study is designed to determine the preliminary efficacy of ED GOAL on increasing ACP engagement (by self-report and in the electronic medical record) one month after leaving the ED.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Arm | Experimental | The intervention will take place in the emergency department or days after an emergency department visit at home/hospital virtually using zoom or phone by our trained clinicians. At the time of follow-up assessments, participants may also receive additional counseling by our trained clinicians as needed. |
|
| Control Arm | No Intervention | No intervention will be conducted (standard of care). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ED GOAL | Behavioral | The emergency department clinician-led, behavioral intervention (ED GOAL) is designed to engage seriously ill yet clinically stable older adults in the emergency department to address their values and preferences towards end-of-life care with their outpatient clinicians. The intervention consists of an interview to discuss participants' values and preferences for end-of-life care. The participants will receive coaching on how to initiate/re-introduce discussions about end-of-life wishes with their loved ones and outpatient clinicians. The participants' outpatient clinicians will also receive a summary of what participants disclosed via email or mailed letter. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Advance Care Planning (ACP) Engagement With Clinicians at One Month | ACP engagement is a one-item question from the validated ACP engagement survey that measures participants' self-reported readiness to discuss their values and preferences with their doctors. The instrument is a 5-point Likert scale ranging from "I have never thought about it (1)" to "I have already done it (5)." A higher score indicates a better outcome. Sudore RL, Heyland DK, Barnes DE, Howard M, Fassbender K, Robinson CA, Boscardin J, You JJ. Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey. J Pain Symptom Manage. 2017 Apr;53(4):669-681.e8. doi: 10.1016/j.jpainsymman.2016.10.367. Epub 2016 Dec 29. PMID: 28042072; PMCID: PMC5730058. | Change from baseline ACP engagement at one month |
| Measure | Description | Time Frame |
|---|---|---|
| Feeling Heard and Understood Survey | A validated instrument for seriously ill patients to report how well they feel heard and understood about their wishes for end-of-life care. This instrument is a 5-point Likert scale: "not at all (1)," "slightly (2)," "moderately (3)," "quite a bit (4)," and "completely (5)." A higher score indicates a better outcome. Gramling R, Stanek S, Ladwig S, Gajary-Coots E, Cimino J, Anderson W, Norton SA; AAHPM Research Committee Writing Group, Aslakson RA, Ast K, Elk R, Garner KK, Gramling R, Grudzen C, Kamal AH, Lamba S, LeBlanc TW, Rhodes RL, Roeland E, Schulman-Green D, Unroe KT. Feeling Heard and Understood: A Patient-Reported Quality Measure for the Inpatient Palliative Care Setting. J Pain Symptom Manage. 2016 Feb;51(2):150-4. doi: 10.1016/j.jpainsymman.2015.10.018. Epub 2015 Nov 17. PMID: 26596879. |
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Inclusion Criteria:
≥50 years of age AND ≥1 Serious illness* OR ED clinician would not be surprised if patient died in the next 12 months (a validated prognostic sign)
English-speaking
Capacity to consent
(*) NYHA Stage III/IV congestive heart failure, chronic obstructive lung disease on home oxygen, chronic kidney disease on dialysis, or metastatic solid tumor cancer. In addition, patients with NYHA Stage I/II congestive heart failure, chronic obstructive lung disease not on home oxygen, chronic kidney disease not on dialysis will be included if recent hospitalization in the last 12 months exists.
Exclusion Criteria:
(**)e.g., MOLST, medical order for life-sustaining treatment, documented serious illness conversations in clinician notes within the last 3 months, etc.
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| Name | Affiliation | Role |
|---|---|---|
| Kei Ouchi, MD, MPH | Brigham and Women's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Brigham and Women's Hospital | Boston | Massachusetts | 02115 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40729413 | Derived | Shiozawa Y, Morton S, Shirai N, Oelschlager H, Kiernat L, Chary AN, Revette AC, Haimovich A, Desai S, Chang KW, Liu SW, Kennedy M, Schonberg MA, Ouchi K. Exploring Patients' Perceptions of an Advance Care Planning Intervention in the Emergency Department: A Qualitative Study. Acad Emerg Med. 2025 Oct;32(10):1076-1083. doi: 10.1111/acem.70109. Epub 2025 Jul 29. | |
| 40531532 |
| Label | URL |
|---|---|
| National Institutes of Health study record | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | Intervention Arm | The intervention will take place in the emergency department or days after an emergency department visit at home/hospital virtually using zoom or phone by our trained clinicians. At the time of follow-up assessments, participants may also receive additional counseling by our trained clinicians as needed. ED GOAL: The emergency department clinician-led, behavioral intervention (ED GOAL) is designed to engage seriously ill yet clinically stable older adults in the emergency department to address their values and preferences towards end-of-life care with their outpatient clinicians. The intervention consists of an interview to discuss participants' values and preferences for end-of-life care. The participants will receive coaching on how to initiate/re-introduce discussions about end-of-life wishes with their loved ones and outpatient clinicians. The participants' outpatient clinicians will also receive a summary of what participants disclosed via email or mailed letter. |
| FG001 | Control Arm | No intervention will be conducted (standard of care). |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1-Month Follow-up |
|
| |||||||||||||||||||||
| 3-Month Follow-up |
| ||||||||||||||||||||||
| 6-Month Follow-up |
|
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Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Intervention Arm | The intervention will take place in the emergency department or days after an emergency department visit at home/hospital virtually using zoom or phone by our trained clinicians. At the time of follow-up assessments, participants may also receive additional counseling by our trained clinicians as needed. ED GOAL: The emergency department clinician-led, behavioral intervention (ED GOAL) is designed to engage seriously ill yet clinically stable older adults in the emergency department to address their values and preferences towards end-of-life care with their outpatient clinicians. The intervention consists of an interview to discuss participants' values and preferences for end-of-life care. The participants will receive coaching on how to initiate/re-introduce discussions about end-of-life wishes with their loved ones and outpatient clinicians. The participants' outpatient clinicians will also receive a summary of what participants disclosed via email or mailed letter. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Advance Care Planning (ACP) Engagement With Clinicians at One Month | ACP engagement is a one-item question from the validated ACP engagement survey that measures participants' self-reported readiness to discuss their values and preferences with their doctors. The instrument is a 5-point Likert scale ranging from "I have never thought about it (1)" to "I have already done it (5)." A higher score indicates a better outcome. Sudore RL, Heyland DK, Barnes DE, Howard M, Fassbender K, Robinson CA, Boscardin J, You JJ. Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey. J Pain Symptom Manage. 2017 Apr;53(4):669-681.e8. doi: 10.1016/j.jpainsymman.2016.10.367. Epub 2016 Dec 29. PMID: 28042072; PMCID: PMC5730058. | Some participants did not complete the 1-month follow-up survey. Thus, the number analyzed is different at baseline compared to the 1-month mark. | Posted | Mean | Standard Deviation | score on a scale | Change from baseline ACP engagement at one month |
|
1 month, 3 months, and 6 months.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Intervention Arm | The intervention will take place in the emergency department or days after an emergency department visit at home/hospital virtually using zoom or phone by our trained clinicians. At the time of follow-up assessments, participants may also receive additional counseling by our trained clinicians as needed. ED GOAL: The emergency department clinician-led, behavioral intervention (ED GOAL) is designed to engage seriously ill yet clinically stable older adults in the emergency department to address their values and preferences towards end-of-life care with their outpatient clinicians. The intervention consists of an interview to discuss participants' values and preferences for end-of-life care. The participants will receive coaching on how to initiate/re-introduce discussions about end-of-life wishes with their loved ones and outpatient clinicians. The participants' outpatient clinicians will also receive a summary of what participants disclosed via email or mailed letter. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Kei Ouchi, MD, MPH | Brigham and Women's Hospital | 6175257771 | kouchi@bwh.harvard.edu |
Not provided
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Dec 7, 2021 | Jan 5, 2022 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D006333 | Heart Failure |
| D009362 | Neoplasm Metastasis |
| D029424 | Pulmonary Disease, Chronic Obstructive |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D009385 | Neoplastic Processes |
| D009369 | Neoplasms |
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|
| Surveys were done at baseline and once at 1, 3, or 6 months. If participants reported discussing end-of-life wishes with their doctor during a follow-up, the survey was given then or at 6 months, whichever came first. Follow-up results were summed. |
| Quality of Communication Survey | A validated instrument to measure the quality of communication about end-of-life care. This instrument is a 10-point Likert scale ranging from "the very worse I could imagine (0)" to "the very best I could imagine (10)". A higher score indicates a better outcome. Engelberg RA, Downey L, Curtis JR. Psychometric characteristics of a quality of communication questionnaire assessing communication about end-of-life care. J Palliat Med. 2006 Oct;9(5):1086-98. | Baseline & 1, 3, or 6 months (same as Outcome 2). Additionally, the baseline questionnaire was asked with respect to the study clinician, whereas the follow-up was asked with respect to the primary doctor. Thus, only the follow-up value is reported. |
| Healthcare Utilization | Electronic medical records will be reviewed to find the number of urgent care visits, ED visits, hospitalizations, hospice visits, and outpatient visits. | At 6 and 12 months before and 1, 6, 12 months after enrollment |
| Mortality | The electronic medical records will be reviewed to find the patients' vital status. | At 1, 3, and 6 months |
| Qualitative Benefits and Obstacles of Advance Care Planning (ACP) Conversations After ED GOAL | Semi-structured interviews to assess the benefits of ED GOAL and obstacles participants faced in completing more ACP conversations with their outpatient clinicians and loved ones after ED GOAL. | At 1, 3, and/or 6 months |
| Electronic Medical Record Documentation of Advance Care Planning (ACP) Conversations | The electronic medical record will be reviewed to find clinician documentation of ACP conversations. | At 1, 3, and 6 months |
| Change in Advance Care Planning (ACP) Engagement With Clinicians at Three Months | ACP engagement is a one-item question from the validated ACP engagement survey that measures participants' self-reported readiness to discuss their values and preferences with their doctors. The instrument is a 5-point Likert scale ranging from "I have never thought about it (1)" to "I have already done it (5)." A higher score indicates a better outcome. Sudore RL, Heyland DK, Barnes DE, Howard M, Fassbender K, Robinson CA, Boscardin J, You JJ. Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey. J Pain Symptom Manage. 2017 Apr;53(4):669-681.e8. doi: 10.1016/j.jpainsymman.2016.10.367. Epub 2016 Dec 29. PMID: 28042072; PMCID: PMC5730058. | Change from baseline ACP engagement at three months |
| Change in Advance Care Planning (ACP) Engagement With Clinicians at Six Months | ACP engagement is a one-item question from the validated ACP engagement survey that measures participants' self-reported readiness to discuss their values and preferences with their doctors. The instrument is a 5-point Likert scale ranging from "I have never thought about it (1)" to "I have already done it (5)." A higher score indicates a better outcome. Sudore RL, Heyland DK, Barnes DE, Howard M, Fassbender K, Robinson CA, Boscardin J, You JJ. Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey. J Pain Symptom Manage. 2017 Apr;53(4):669-681.e8. doi: 10.1016/j.jpainsymman.2016.10.367. Epub 2016 Dec 29. PMID: 28042072; PMCID: PMC5730058. | Change from baseline ACP engagement at six months |
| Participant-reported Completion of Advance Care Planning (ACP) Conversations | Participants are asked if they had completed ACP conversations with their loved ones and clinicians. | At 1, 3, and 6 months |
| Ouchi K, Block SD, Rentz DM, Berry DL, Oelschlager H, Shiozawa Y, Rossmassler S, Berger AL, Hasdianda MA, Wang W, Boyer E, Sudore RL, Tulsky JA, Schonberg MA. Serious Illness Conversations in the Emergency Department for Older Adults With Advanced Illnesses: A Randomized Clinical Trial. JAMA Netw Open. 2025 Jun 2;8(6):e2516582. doi: 10.1001/jamanetworkopen.2025.16582. |
| 36210436 | Derived | Prachanukool T, Block SD, Berry D, Lee RS, Rossmassler S, Hasdianda MA, Wang W, Sudore R, Schonberg MA, Tulsky JA, Ouchi K. Emergency department-based, nurse-initiated, serious illness conversation intervention for older adults: a protocol for a randomized controlled trial. Trials. 2022 Oct 9;23(1):866. doi: 10.1186/s13063-022-06797-6. |
| Discontinued |
|
| NOT COMPLETED |
|
|
| NOT COMPLETED |
|
|
| BG001 | Control Arm | No intervention will be conducted (standard of care). |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Age, Customized | Median | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Serious Illness | Count of Participants | Participants |
|
| Intervention Arm |
The intervention will take place in the emergency department or days after an emergency department visit at home/hospital virtually using zoom or phone by our trained clinicians. At the time of follow-up assessments, participants may also receive additional counseling by our trained clinicians as needed. ED GOAL: The emergency department clinician-led, behavioral intervention (ED GOAL) is designed to engage seriously ill yet clinically stable older adults in the emergency department to address their values and preferences towards end-of-life care with their outpatient clinicians. The intervention consists of an interview to discuss participants' values and preferences for end-of-life care. The participants will receive coaching on how to initiate/re-introduce discussions about end-of-life wishes with their loved ones and outpatient clinicians. The participants' outpatient clinicians will also receive a summary of what participants disclosed via email or mailed letter. |
| OG001 | Control Arm | No intervention will be conducted (standard of care). |
|
|
|
| Secondary | Feeling Heard and Understood Survey | A validated instrument for seriously ill patients to report how well they feel heard and understood about their wishes for end-of-life care. This instrument is a 5-point Likert scale: "not at all (1)," "slightly (2)," "moderately (3)," "quite a bit (4)," and "completely (5)." A higher score indicates a better outcome. Gramling R, Stanek S, Ladwig S, Gajary-Coots E, Cimino J, Anderson W, Norton SA; AAHPM Research Committee Writing Group, Aslakson RA, Ast K, Elk R, Garner KK, Gramling R, Grudzen C, Kamal AH, Lamba S, LeBlanc TW, Rhodes RL, Roeland E, Schulman-Green D, Unroe KT. Feeling Heard and Understood: A Patient-Reported Quality Measure for the Inpatient Palliative Care Setting. J Pain Symptom Manage. 2016 Feb;51(2):150-4. doi: 10.1016/j.jpainsymman.2015.10.018. Epub 2015 Nov 17. PMID: 26596879. | The number analyzed at follow-up differs from the overall number as not all participants completed the follow-up survey. | Posted | Count of Participants | Participants | Surveys were done at baseline and once at 1, 3, or 6 months. If participants reported discussing end-of-life wishes with their doctor during a follow-up, the survey was given then or at 6 months, whichever came first. Follow-up results were summed. |
|
|
|
| Secondary | Quality of Communication Survey | A validated instrument to measure the quality of communication about end-of-life care. This instrument is a 10-point Likert scale ranging from "the very worse I could imagine (0)" to "the very best I could imagine (10)". A higher score indicates a better outcome. Engelberg RA, Downey L, Curtis JR. Psychometric characteristics of a quality of communication questionnaire assessing communication about end-of-life care. J Palliat Med. 2006 Oct;9(5):1086-98. | Posted | Mean | Standard Deviation | score on a scale | Baseline & 1, 3, or 6 months (same as Outcome 2). Additionally, the baseline questionnaire was asked with respect to the study clinician, whereas the follow-up was asked with respect to the primary doctor. Thus, only the follow-up value is reported. |
|
|
|
| Secondary | Healthcare Utilization | Electronic medical records will be reviewed to find the number of urgent care visits, ED visits, hospitalizations, hospice visits, and outpatient visits. | Posted | Median | Full Range | visits | At 6 and 12 months before and 1, 6, 12 months after enrollment |
|
|
|
| Secondary | Mortality | The electronic medical records will be reviewed to find the patients' vital status. | Posted | Count of Participants | Participants | At 1, 3, and 6 months |
|
|
|
| Secondary | Qualitative Benefits and Obstacles of Advance Care Planning (ACP) Conversations After ED GOAL | Semi-structured interviews to assess the benefits of ED GOAL and obstacles participants faced in completing more ACP conversations with their outpatient clinicians and loved ones after ED GOAL. | Only participants from the intervention arm were included in the qualitative study because the purpose of the qualitative analysis was to explore participants' experiences and perceptions specific to the ED GOAL intervention. Participants in the control arm did not receive the intervention and therefore were not eligible for this portion of the study. | Posted | Count of Participants | Participants | At 1, 3, and/or 6 months |
|
|
|
| Secondary | Electronic Medical Record Documentation of Advance Care Planning (ACP) Conversations | The electronic medical record will be reviewed to find clinician documentation of ACP conversations. | Posted | Count of Participants | Participants | At 1, 3, and 6 months |
|
|
|
| Secondary | Change in Advance Care Planning (ACP) Engagement With Clinicians at Three Months | ACP engagement is a one-item question from the validated ACP engagement survey that measures participants' self-reported readiness to discuss their values and preferences with their doctors. The instrument is a 5-point Likert scale ranging from "I have never thought about it (1)" to "I have already done it (5)." A higher score indicates a better outcome. Sudore RL, Heyland DK, Barnes DE, Howard M, Fassbender K, Robinson CA, Boscardin J, You JJ. Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey. J Pain Symptom Manage. 2017 Apr;53(4):669-681.e8. doi: 10.1016/j.jpainsymman.2016.10.367. Epub 2016 Dec 29. PMID: 28042072; PMCID: PMC5730058. | Some participants did not complete the 3-month follow-up survey. Thus, the number analyzed is different at baseline compared to the 3-month mark. | Posted | Mean | Standard Deviation | score on a scale | Change from baseline ACP engagement at three months |
|
|
|
| Secondary | Change in Advance Care Planning (ACP) Engagement With Clinicians at Six Months | ACP engagement is a one-item question from the validated ACP engagement survey that measures participants' self-reported readiness to discuss their values and preferences with their doctors. The instrument is a 5-point Likert scale ranging from "I have never thought about it (1)" to "I have already done it (5)." A higher score indicates a better outcome. Sudore RL, Heyland DK, Barnes DE, Howard M, Fassbender K, Robinson CA, Boscardin J, You JJ. Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey. J Pain Symptom Manage. 2017 Apr;53(4):669-681.e8. doi: 10.1016/j.jpainsymman.2016.10.367. Epub 2016 Dec 29. PMID: 28042072; PMCID: PMC5730058. | Some participants did not complete the 6-month follow-up survey. Thus, the number analyzed is different at baseline compared to the 6-month mark. | Posted | Mean | Standard Deviation | score on a scale | Change from baseline ACP engagement at six months |
|
|
|
| Secondary | Participant-reported Completion of Advance Care Planning (ACP) Conversations | Participants are asked if they had completed ACP conversations with their loved ones and clinicians. | Some participants did not complete the follow-up surveys. | Posted | Count of Participants | Participants | At 1, 3, and 6 months |
|
|
|
| 4 |
| 70 |
| 0 |
| 70 |
| 0 |
| 70 |
| EG001 | Control Arm | No intervention will be conducted (standard of care). | 4 | 71 | 0 | 71 | 0 | 71 |
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| D010335 |
| Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| Slightly |
|
| Moderately |
|
| Quite a bit |
|
| Completely |
|
| Follow-up |
|
|
| How good is your doctor at talking to you about HOW LONG you might have to live? |
|
| How good is your doctor at talking with you about WHAT DYING MIGHT BE LIKE? |
|
| How good is doctor at involving you in DECISIONS ABOUT TREATMENTS you want if you get too sick? |
|
| How good is your doctor at asking about the things in life that are IMPORTANT TO YOU? |
|
| How good is your doctor at asking about your SPIRITUAL OR RELIGIOUS beliefs? |
|
| ED Visits 6 Months Prior |
|
| ED Visits 12 Months Prior |
|
| Hospitalizations 6 Months Prior |
|
| Hospitalizations 12 Months Prior |
|
| ED Visits 1 Month After |
|
| ED Visits 6 Months After |
|
| ED Visits 12 Months After |
|
| Outpatient Visits 1 Month After |
|
| Outpatient Visits 6 Months After |
|
| Outpatient Visits 12 Months After |
|
| Hospitalizations 1 Month After |
|
| Hospitalizations 6 Months After |
|
| Hospitalizations 12 Months After |
|
| Title | Measurements |
|---|---|
|
| Making wishes known |
|
| No effect on attitudes toward ACP |
|
| Spoke with clinician |
|
| Spoke with family/loved ones |
|
| No action taken towards ACP |
|
| Medical Orders for Life-Sustaining Treatment (MOLST) completed |
|
| Living will completed |
|
| HCP/Power of attorney completed |
|
| Helped conversation with clinician |
|
| Motivated to initiate conversation with clinician |
|
| Clarified specific wishes through conversation with clinician |
|
| No effect on conversation with clinician |
|
| Would recommend others to have ACP conversation with clinician |
|
| No opportunity to have a conversation with clinician |
|
| HCP aware, no need to tell clinician |
|
| Not a priority to have a conversation with clinician |
|
| Not sick enough to have a conversation with clinician |
|
| Don't understand what ACP is to have a conversation with clinician |
|
| Uncomfortable to have a conversation with clinician |
|
| Lessened the burden on loved ones |
|
| Prepared loved ones |
|
| Helped conversation with love dones |
|
| Clarified specific wishes through conversation with loved ones |
|
| Motivated to initiate conversation with loved ones |
|
| No effect on conversation with loved ones |
|
| Would recommend others to have ACP conversation with loved ones |
|
| Would not/maybe recommend others to have ACP conversation with loved ones |
|
| No opportunity to have a conversation with loved ones |
|
| Don't understand what ACP is to have a conversation with loved ones |
|
| Not a priority to have a conversation with loved ones |
|
| No one to talk with |
|
| Family not ready to have a conversation |
|
| Already had a conversation with loved ones |
|
| Positive effect on attitudes towards crisis |
|
| No effect on attitudes towards crisis |
|
| Positive effect on end-of-life decision making |
|
| Negative effect on end-of-life decision making |
|
| No effect on end-of-life decision making |
|
| 3-Month |
|
| 6-Month |
|
| 3-Month |
|
|
| 6-Month |
|
|
| Have you talked to loved ones about medical care you would want if you were too sick to speak? (Yes) |
|
| 3-Month |
|
|
| 6-Month |
|
|