Patient Engagement Initiative

Study Overview
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Brief Summary
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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.

Official Title
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Engaging Surrogates and Physicians to Ensure Concordant Critical Care

Conditions
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Critical Illness

Intervention / Treatment
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* Behavioral: Consideration of 3-month functional prognosis


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>Prompts standard to rounds or electronic medical records. | |
| Experimental: Prompting Intervention<br>Prompting consideration of 3-month functional outcome. | Behavioral: Consideration of 3-month functional prognosis<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | 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 Outcome Measures

| Outcome Measure | Measure Description | 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 | 
| Prevalence of the discussed option of stopping life support as assessed by blinded assessors |  | 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 | 
| Consulting services requested by study participants |  | 0 to 5 minutes after prompting an intervention |