Implementing, Evaluating, and Scaling Up of the Strengthening a Palliative Approach in Long Term Care (SPA-LTC) Program

McMaster University

Status: Active, not recruiting

Conditions: Frail Elderly Syndrome

Treatments: Other: Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) Program

Study type: Interventional

Funder types: Other

Identifiers

NCT03935997

SPA-LTC408466

Details and patient eligibility

About

This study will evaluate the implementation of the Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) program using a cross-jurisdictional, effectiveness-implementation type II hybrid design (dual testing of clinical and implementation interventions) to assess the implementation (feasibility, fidelity, reach, sustainability) and effectiveness (family satisfaction, staff knowledge and confidence implementing a palliative approach to care, hospital use).

Full description

The SPA-LTC program has been developed and refined through prior participatory action based studies.

Evidence-based components of the program include:

Palliative Champion Teams; Palliative Care Education, including illness-trajectory pamphlets for staff and family members; Comfort Care Rounds with staff; Prognostic Tools to trigger end-of-life discussions; Palliative Care Conferences; Bereavement Pamphlets for families; and Post-Bereavement Follow-Up for families, and staff

The goal is to implement and assess this program across three provinces in Canada (Ontario, Saskatchewan, Manitoba). The investigators will use the findings to revise the program and inform the scaling up of the program across diverse settings and provinces.

Enrollment: 594 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• English-speaking LTC residents with a score of 50% or less on the Palliative Performance Scale.

Exclusion criteria

• Non-English speaking LTC residents
• residents with a score of more than 50% on the Palliative Performance Scale.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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594 participants in 2 patient groups

Intervention

Experimental group

Description:

Within the intervention arm 9 long-term care homes will receive the SPA-LTC program:3 in Ontario; 3 in Saskatchewan and 3 in Manitoba.

Treatment:

Other: Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) Program

Control

No Intervention group

Description:

Within the control arm 9 long-term care homes will receive the standard of care: 3 in Ontario; 3 in Saskatchewan and 3 in Manitoba.