N/A
N=134
Evaluation of Methods for Implementation of a Comfort Care Order Set
Terminal Conditions, End of Life
Bottom Line
View on ClinicalTrials.gov: NCT02383173 ↗Enrolled (actual)
134
Serious AEs
—
Results posted
Dec 2020
Primary outcome: Primary: Presence of an Active Opioid Order at Time of Death — 1330; 1543 Participants — p=0.445
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Basic Implementation Approach (Other); Enhanced Implementation Approach (Other)
- Age
- Pediatric, Adult, Older Adult
- Sex
- All
- Sponsor
- VA Office of Research and Development
- Primary completion
- Apr 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Presence of an Active Opioid Order at Time of Death |
1330; 1543 | 0.445 |
| SECONDARY Presence of an Order for Benzodiazepine Medication |
1025; 1117 | — |
| SECONDARY Presence of a Do-not-resuscitate Order |
1336; 1504 | — |
| SECONDARY Presence of a Palliative Care Consult Order |
1208; 1426 | — |
| SECONDARY Location of Death |
436; 408 | — |
| SECONDARY Presence of a Nasogastric Tube |
161; 141 | — |
| SECONDARY Presence of an Intravenous Line |
141; 184 | — |
| SECONDARY Presence of Restraints |
86; 73 | — |
| SECONDARY Presence of a Pastoral Care Visit |
1060; 1271 | — |
Summary
The overarching goal of this research program is to improve the quality of end-of-life care provided to Veterans dying in VA Medical Centers (VAMCs), by transferring the best practices of home hospice and palliative care for the last days and hours of life into the inpatient setting. This trial will examine two methods of delivering a Comfort Care Education Intervention utilizing the established infrastructure of VA Palliative Care Consult Teams (PCCT): a Basic Implementation Approach using a teleconference to review educational materials and activate PCCTs to educate other providers, and an Enhanced Implementation Approach utilizing in-person, train-the-"champion" workshops to prepare PCCT members to be leaders and trainers at their home sites. Findings will provide a robust evaluation of the implementation process, and will be used to refine the Comfort Care Education Intervention and implementation strategies in preparation for nationwide dissemination of best practices for end-of-life care within the VA Healthcare System.
Eligibility Criteria
Inclusion Criteria
To be eligible, each provider had to be a member of a VA palliative care consult team (PCCT)
Exclusion Criteria
VAMCs were excluded if the facility scored in the top 10th percentile or lowest 10th percentile on PROMISE after-death survey; if they had no prescribing provider on the PCCT team; or if there were fewer than 30 deaths in VAMC during the reporting period
Data sourced from ClinicalTrials.gov (NCT02383173). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.