Timing of Acute Palliative Care Consultation in Critically Ill Patient
A Randomized Allocation of Palliative Care Consultation in the Emergency Department Compared to Usual Practice
What it found
We found no results in the registry or in papers.
What was tested
Treatment tested
- Early order of palliative care consultation
What it measured
Main measures
The difference in the percentage of patients with a completed advance directive (AD) in Ig vs.Cg
1 year
Other measures (9)
The proportion of billed CMS ACP-CPT codes in Ig vs. Cg
30 days from enrolled patients' hospital discharge
Matches of care received to patient-specific preferences in Ig vs. Cg
1 year
PainQuality of life (reported by participants)Patient/family satisfaction with care in Ig vs. Cg
Baseline
Quality of life (reported by participants)Amount of hospice referrals in Ig vs. Cg
1 year
Hospital total direct costs for the index visit in Ig vs. Cg
1 year
Hospital and ICU length of stay in Ig vs. Cg
1 year
Average days in hospice in Ig vs. Cg
1 year
Hospital margin contribution for the index visit in Ig vs. Cg
1 year
Time to consultation in Ig vs. Cg groups
1 year
Who could take part
MS (type not specified) · 65 and over
Show the full criteria
Inclusion criteria
* Greater than or equal to 65 years old * Treated in a resuscitation room for unstable vital signs or respiratory compromise * One or more of the following: * Advanced or metastatic solid organ cancer * End stage organ failure of the heart, lung/COPD, kidney on dialysis, hepatic encephalopathy * Suspected sepsis * Advanced dementia, end-state multiple sclerosis or Parkinson's disease * Status post cardiac arrest with coma (Glascow coma score \<7) * Patient is from a skilled nursing facility
Exclusion criteria
* Lack decision capacity and have no relative available during ED stay to consent to the study (legally authorized representative-LAR) * Enrolled in hospice care prior to randomization * A copy of a completed advance directive which names a designated proxy provided physically to the medical team prior to randomization * Wearing a DNR bracelet * Have been previously enrolled in this study
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
A prospective randomized controlled trial studying the ordering of palliative care consultations in the emergency department (Ig) versus later palliative care consultations in the hospital--ICU or hospital ward(Cg). Patients will be randomly allocated to Ig or Cg with a 1:1 ratio.
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History
Started
Jun 2016
Main results due
Jan 2017