Integrating Palliative and Critical Care (IPACC) Study (IPACC)
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.|
|ClinicalTrials.gov Identifier: NCT00685893|
Recruitment Status : Completed
First Posted : May 29, 2008
Last Update Posted : June 27, 2013
- Study Details
- Tabular View
- No Results Posted
- How to Read a Study Record
|Condition or disease||Intervention/treatment||Phase|
|Any Disease Causing Death in the ICU or Within 24 Hours of Discharge From the ICU||Behavioral: Education Behavioral: Local Champions Behavioral: Institution Feedback Behavioral: Academic Detailing Behavioral: Institutional Forms||Phase 3|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||3498 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Primary Purpose:||Supportive Care|
|Official Title:||An ICU Intervention to Improve End-of-Life Care|
|Study Start Date :||June 2003|
|Actual Primary Completion Date :||March 2008|
|Actual Study Completion Date :||October 2010|
No Intervention: Control Arm
6 Community hospital ICUs receiving delayed intervention activities after the completion of the randomized trial
Experimental: Intervention Arm
6 community hospital ICUs receiving 5-component intervention.
We include information about end-of-life decision-making, communication skills, pain and symptom management, and withdrawal of life support. The primary methods of delivery will be a grand rounds lecture by one of the physician investigators and the viewing of an educational video for nurses and respiratory therapists. The content of the educational components will be structured to cover four topics: the principles of decision-making about end-of-life care in the ICU; communication with patients, families and the ICU team; pain and symptom management; and, the principles and practice of withdrawal of life support.
Behavioral: Local Champions
We identify physicians, nurses and other clinicians from each hospital to serve as the local champions. The role of the local champions is to help implement the intervention and be a role model for end-of-life care in the ICU. Local champions participate in interactive education and training sessions with the investigators and the other local champions from their institution to discuss barriers to good end-of-life care at their location and to strategize about how to overcome those barriers.
Behavioral: Institution Feedback
We provide feedback to the institution from the hospital specific family satisfaction data we collect. All feedback is presented as aggregated data for the institution without any personal identifiers.
Behavioral: Academic Detailing
Study staff meet with ICU directors with 4 goals. The first goal is to familiarize the director with the educational content of the intervention. Secondly, the results of the family satisfaction data collected are shared without identifying information. The aggregated results of the other participating hospitals are disclosed, also without identifiers. Third, we elicit and discuss the institution-specific barriers to providing high quality end-of-life care in the ICU. Lastly, we hope that by educating the directors we can engage these clinical leaders to serve as role models in their institutions.
Behavioral: Institutional Forms
We have developed a set of orders that encompass the various aspects of withdrawing life support from patients. Individual department directors at each hospital will decide if they want to implement a similar order form at their institution and whether they want to modify the form to fit their specific institutional needs. In addition to the order forms, we encourage hospitals to develop a family pamphlets and resources that can be given to families to provide education about the intensive care unit experience.
- Total Score on a survey: the Quality of Dying and Death (QODD) as assessed by family members. [ Time Frame: 5 years ]
- Total score of the QODD, as assessed by nurses [ Time Frame: 5 years ]
- Satisfaction with care, as assessed by a survey called Family Satisfaction with the ICU (FS-ICU) as assessed by family members [ Time Frame: 5 years ]
- Indicators of quality of end-of-life care as assessed by standardized medical record review. [ Time Frame: 5 years ]
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
|Ages Eligible for Study:||18 Years and older (Adult, Older Adult)|
|Sexes Eligible for Study:||All|
|Accepts Healthy Volunteers:||No|
- patients, family members, nurses, and clinician evaluators
Patients are eligible if they are:
- in the ICU for a minimum of 6 hours AND,
- if they die in an ICU or within 24 hours of transfer out of the ICU.
Family members or significant others are eligible if:
- they were involved with the patient who has died.
Nurses are eligible if:
- they cared for an eligible patient on either the shift during which the patient died or the shift preceding the death.
Clinicians are eligible to evaluate the intervention components if they:
- work in a study ICU AND
- participate in any of the intervention components.
- Inability to read English well enough to complete the surveys
- Under 18 years of age.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00685893
|United States, Washington|
|Overlake Hospital Medical Center|
|Bellevue, Washington, United States, 98004|
|Harrison Memorial Hospital|
|Bremerton, Washington, United States, 98310|
|Highline Medical Center|
|Burien, Washington, United States, 98166|
|Edmonds, Washington, United States, 98056|
|Evergreen Hospital Medical Center|
|Kirkland, Washington, United States, 98034|
|Valley Medical Center|
|Renton, Washington, United States, 98058|
|Virginia Mason Medical Center|
|Seattle, Washington, United States, 98101|
|University of Washington; Harborview Medical Center|
|Seattle, Washington, United States, 98104|
|Swedish Medical Center; Ballard Campus|
|Seattle, Washington, United States, 98107|
|Veteran's Affairs Puget Sound HCS|
|Seattle, Washington, United States, 98108|
|Swedish Medical Center; Cherry Hill Campus|
|Seattle, Washington, United States, 98112|
|Swedish Medical Center; First Hill Campus|
|Seattle, Washington, United States, 98122|
|Northwest Hospital Medical Center|
|Seattle, Washington, United States, 98133|
|University of Washington; UW Medical Center|
|Seattle, Washington, United States, 98195|
|Saint Joseph Hospital|
|Tacoma, Washington, United States, 98405|
|Principal Investigator:||J. Randall Curtis, MD, MPH||University of Washington; Division of Pulmonary and Critical Care|
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
|Responsible Party:||J. Randall Curtis, Professor of Medicine, University of Washington|
|Other Study ID Numbers:||
R01NR005226 ( U.S. NIH Grant/Contract )
|First Posted:||May 29, 2008 Key Record Dates|
|Last Update Posted:||June 27, 2013|
|Last Verified:||June 2013|
Talking with your doctor
Coping with chronic illness