Ignite Creation Date:
2024-05-06 @ 8:09 PM
Last Modification Date:
2024-10-26 @ 3:21 PM
Study NCT ID:
NCT06277310
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2024-04-02
First Post:
2024-02-13
Brief Title:
Implementation of the 3 Wishes Project in Safety-Net Hospitals
Sponsor:
University of California Los Angeles
Organization:
University of California Los Angeles
Study Overview
Official Title:
Personalized End of Life Care in Safety-Net Hospitals Implementation of the 3 Wishes Project
Status:
ACTIVE_NOT_RECRUITING
Status Verified Date:
2024-03
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Dignified and compassionate end-of-life EOL care is a cornerstone of high-quality patient-centered care but in safety-net hospitals EOL care is often overlooked considered too late or not at all By eliciting and implementing final wishes for dying patients the 3 Wishes Project 3WP has demonstrated in tertiary academic centers that acts of compassion can improve the EOL experience and help families cope with loss The investigators propose to implement the 3WP in safety-net hospitals where there are less resources and more diverse disadvantaged patient populations and hypothesize that there will be similar positive effects on the EOL experience for patients families and clinicians
Detailed Description:
Compassionate end-of-life EOL care is foundational to medicine but providing patients and families in safety-net hospitals SNHs with the sense that they are physically and emotionally supported during a patients terminal hospitalization can be challenging SNHs are public hospitals that primarily provide services to low-income and uninsured patients on a minimal budget Although high quality EOL care is an important unmet need in SNHs its provision is fraught with barriers and challenges Language barriers low health literacy and cultural differences can make it difficult for families in SNHs to perceive empathy and support during the EOL Deaths in the intensive care unit ICU for underserved families can be traumatic and families of patients who die in the ICU often suffer from depression and post-traumatic stress disorder Palliative care interventions are needed but implementation is often resource-prohibitive
The 3 Wishes Project 3WP is a palliative care intervention that aims to achieve a dignified and compassionate EOL experience by empowering the clinical team to elicit and fulfill small wishes for critically ill patients who are dying in the ICU Although the 3WP has been shown to improve a familys experience of their loved ones EOL care ease bereavement and enhance clinician work satisfaction in academic centers it has not been implemented and evaluated in low-resource hospitals The investigators believe that this patient-centered and clinician-partnered initiative can improve the EOL experience in SNHs but that it must be adapted to the contextual differences and needs of low-resource hospitals
Investigators propose to obtain and use stakeholder input to customize a multi-component 3WP Toolkit that will facilitate 3WP implementation in SNHs Using the tailored Toolkit the investigators will implement and evaluate the 3WP in the three SNHs of the Los Angeles County Department of Health Services The investigators will conduct a pragmatic type 2 hybrid effectiveness-implementation study to evaluate the quality of EOL ICU care bereaved families psychological symptoms and clinician burnout as compared to usual care The Consolidated Framework for Implementation Research CFIR and the RE-AIM Reach Effectiveness Adoption Implementation and Maintenance framework will be used to guide a mixed-methods evaluation of the 3WP implementation in SNHs
The 3 Wishes Project 3WP is a palliative care intervention that aims to achieve a dignified and compassionate EOL experience by empowering the clinical team to elicit and fulfill small wishes for critically ill patients who are dying in the ICU Although the 3WP has been shown to improve a familys experience of their loved ones EOL care ease bereavement and enhance clinician work satisfaction in academic centers it has not been implemented and evaluated in low-resource hospitals The investigators believe that this patient-centered and clinician-partnered initiative can improve the EOL experience in SNHs but that it must be adapted to the contextual differences and needs of low-resource hospitals
Investigators propose to obtain and use stakeholder input to customize a multi-component 3WP Toolkit that will facilitate 3WP implementation in SNHs Using the tailored Toolkit the investigators will implement and evaluate the 3WP in the three SNHs of the Los Angeles County Department of Health Services The investigators will conduct a pragmatic type 2 hybrid effectiveness-implementation study to evaluate the quality of EOL ICU care bereaved families psychological symptoms and clinician burnout as compared to usual care The Consolidated Framework for Implementation Research CFIR and the RE-AIM Reach Effectiveness Adoption Implementation and Maintenance framework will be used to guide a mixed-methods evaluation of the 3WP implementation in SNHs
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None