Critical Illness
Conditions
Brief summary
A no-cost intervention may improve adherence with a recommendation for higher-quality, lower-cost care for patients with critical illness endorsed by a collaborative of critical care societies. The investigators propose prompting consideration of functional outcomes. This trial will help establish the impact of the intervention on practice patterns including proxy engagement and elements of shared decision-making.
Interventions
BEHAVIORALConsideration of 3-month functional prognosis
Sponsors
Gordon and Betty Moore Foundation
Johns Hopkins University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
25 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Licensed physicians * At least 4 weeks of clinical work in an I.C.U. in the U.S.A. during the past 12 months
Exclusion criteria
* \<25 years old * Non-English speaking * Primarily practicing medicine outside the U.S.A.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Presence of acceptable treatment option as assessed by a checklist completed by clinical colleges. | 0 to 5 minutes after prompting an intervention |
Secondary
| Measure | Time frame |
|---|---|
| Level of conflict with proxy with a previously validated single question | 0 to 5 minutes after prompting an intervention |
| Level of shared decision-making measured using CollaboRATE scale | 0 to 5 minutes after prompting an intervention |
| Prevalence of communication skills for involving ICU proxies in treatment decisions assessed by a checklist completed by clinical colleges | 0 to 5 minutes after prompting an intervention |
| Medical interactions assessed using the Roter Interaction Analysis System (RIAS) | 0 to 5 minutes after prompting an intervention |
| Consulting services requested by study participants | 0 to 5 minutes after prompting an intervention |
| Prevalence of conveying prognosis as assessed by blinded assessors | 0 to 5 minutes after prompting an intervention |
| Level of shared decision-making measured using CollaboRATE scale as assessed by blinded assessors | 0 to 5 minutes after prompting an intervention |
| The Observer OPTIONS5 measure completed by blinded assessors | 0 to 5 minutes after prompting an intervention |
| Prevalence of the discussed option of stopping life support as assessed by blinded assessors | 0 to 5 minutes after prompting an intervention |
Countries
United States
Outcome results
None listed