Advance Care Planning: Communicating With Outpatients for Vital Informed Decision (ACP-COVID)
Status
Completed
Conditions
Video Decision Aids
Shared Decision Making
Communication Skills
Natural Language Processing
Covid19
Advanced Care Planning
Advance Directives
Treatments
Other: VitalTalk communication skills training
Other: Intervention training:
Other: ACP Decisions Video Program
Other: Medical Record Review
Study type
Observational
Funder types
Other
NIH
Identifiers
Details and patient eligibility
About
This Pre-Post, open-cohort design, pragmatic trial with 150 clinicians and will evaluate the effectiveness of the use of telehealth Advanced Care Planning (ACP) Program by comparing ACP documentation among 13,000 patients over 65
Full description
This study is investigating if the use of telehealth ACP Program will improve and sustain rates of ACP from the time that the intervention is implemented compared to two time periods prior to the intervention. The Comprehensive ACP Program combines two widely disseminated interventions to assess impact when used concurrently.
- One is VitalTalk clinician communication skills training (www.vitaltalk.org) during which the primary care clinicians will practice ACP with simulated patient actors under the guidance of a trained VitalTalk facilitator.
- The second is the ACP Decisions video decision aids (www.acpdecisions.org) which are directed to patients and provide education about ACP. This inclusive ACP approach treats patients and clinicians as equal stakeholders providing both with the communication skills and tools needed to make decisions about COVID-19 medical care before the toughest choices arise.
- The training is four cumulative hours, most of which is spent in communication skills work, and the remainder learning how to introduce the videos into one's practice. No patients participate in the training. The ambulatory practices included in this intervention gain access to the ACP Decisions videos, which can be introduced to patients. Videos may be seen in clinic or sent to patients' homes via an electronic or paper code.
- We will recruit up to 30 clinicians from participating clinics who completed the intervention training and ask them to complete a qualitative interview to learn about their experience with the ACP intervention.
Enrollment
42,019 patients
Sex
All
Ages
65+ years old
Volunteers
Accepts Healthy Volunteers
Inclusion criteria
- Clinic Eligibility: Clinics affiliated with Northwell Health may be included in the study.
- Clinician, Staff Eligibility: Any staff member identified by the site-PIs are affiliated with Northwell Health.
- Patient Eligibility: To be eligible for this study, individuals must be aged 65 or over, affiliated with the Northwell Health clinic. For each of the three periods of the study, those patients over the age of 65 who are engaged (e.g., seen in person, telehealth, etc.) with the clinic during that time period will be included in that time period
Exclusion criteria
- Individuals who are not yet adults (infants, children, teenagers)
- Pregnant women
- Prisoners
Trial design
42,019 participants in 3 patient groups
Pre-COVID-19 ACP baseline
Description:
Two six-month control periods prior to the wide-scale implementation of the intervention, allow us to measure a baseline rate of ACP activity and identify the "pre-COVID-19 ACP baseline rate" and a "COVID-19 ACP baseline rate.
September 15, 2019 - March 14, 2020,
Treatment:
Other: Medical Record Review
COVID-19 rate
Description:
Two six-month control periods prior to the wide-scale implementation of the intervention, allow us to measure a baseline rate of ACP activity and identify the "pre-COVID-19 ACP baseline rate" and a "COVID-19 ACP baseline rate.
March 15, 2020 - September 14, 2020
Treatment:
Other: Medical Record Review
ACP rate
Description:
ACP rate during the implementation period, which begins December 15, 2020 and continues for six months, to the rates in the previous two control periods December 15, 2020-June 15, 2021
Treatment:
Other: Intervention training:
Other: ACP Decisions Video Program
Other: Medical Record Review
Other: VitalTalk communication skills training
Trial contacts and locations
1
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Data sourced from clinicaltrials.gov
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