N/A
N=163
EFFICACY: Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning by Hospitalists
Advance Care Planning
Bottom Line
View on ClinicalTrials.gov: NCT04557930 ↗Enrolled (actual)
163
Serious AEs
0.0%
Results posted
Feb 2023
Primary outcome: Primary: Percentage of Patients With Advance Care Planning Bills — 5,298; 4,920 Participants — p=0.41
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Hopewell Hospitalist Video Game (Behavioral)
- Age
- Pediatric, Adult, Older Adult
- Sex
- All
- Sponsor
- Dartmouth-Hitchcock Medical Center
- Primary completion
- May 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Patients With Advance Care Planning Bills |
5,298; 4,920 | 0.41 |
| SECONDARY Percentage of Patients Who Died While in Hospital |
1625; 1862 | — |
| SECONDARY Percentage of Patients Readmitted in 7 Days |
756; 750 | — |
| SECONDARY Percentage of Patients Readmitted Within 30-days |
2,065; 2,190 | — |
| SECONDARY Percentage of Patients Who Received Critical Care |
1,065; 1,034 | — |
| SECONDARY Length of Stay |
6.5; 6.4 | — |
Summary
Hopewell Hospitalist is a theory-based adventure video game designed to increase the likelihood that a physician will engage in an advance care planning (ACP) conversation with a patient over the age of 65. Drawing on the theory of narrative engagement, players assume the persona of a hospitalist and navigate a series of clinical encounters with seriously-ill patients over the age of 65. Players experience the consequences of having (or not having) ACP conversations in a timely fashion. The planned study is a pragmatic stepped-wedge crossover phase III trial testing the efficacy of Hopewell Hospitalist for increasing ACP rates measured by ACP billing frequency.
Eligibility Criteria
Hospital Inclusion Criteria:
- Value-based delivery model of care (Bundled Payment Care Initiative)
- Staffed by Sound Physicians for at least 2 quarters
- Advance care planning billing rate in prior quarter greater than 0 percent
- Employs a nurse liaison
- Hospitalist chief approval to approach hospitalists
Hospital Exclusion Criteria:
- Sound Physicians no longer staffing the hospital
- Not staffed by Sound Physicians for at least 2 quarters
- Advance care planning billing rate in prior quarter of 0 percent
- Does not employ a nurse liaison
- Hospitalist chief disapproval to approach hospitalists
- Hospitalist chief does not provide contact information for hospitalists
- Target number of hospitalists for the "step" has been met or exceeded
Hospitalist Inclusion Criteria:
- Employed by Sound for at least 2 quarters and staffing an eligible hospital for at least 1 quarter
- ACP billing rate in prior quarter greater than 0 percent or answers eligibility question affirming use of ACP billing codes
- Provides informed consent
- Name matches a name in the contact list for the sample; OR is verified by communication through an employer-based email address
- Receipt of a functional iPad within study step time frame
Hospitalist Exclusion Criteria:
- Not employed by Sound for at least 2 quarters and staffing an eligible hospital for at least 1 quarter
- ACP billing rate in prior quarter of 0 percent or answers eligibility question refusing use of ACP billing
- Does not provide informed consent
- Provides consent after the given deadline for consenting
- Name does not match a name in the contact list for the sample; OR cannot be verified by communication through an employer-based email address
- Receipt of a nonfunctional iPad within study step time frame
- If the number of participants who consent per site exceeds targets, then participants who are part-time employees will be preferentially excluded
Data sourced from ClinicalTrials.gov (NCT04557930). 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.