Clinical Trials Logo

Clinical Trial Summary

All patients admitted to London Health Sciences Centre (LHSC) are asked to indicate their preferences for CPR (cardiopulmonary resuscitation) and other life-sustaining treatments that necessitate an Intensive Care Unit (ICU) admission.

Complex, high-risk patients at LHSC require multiple admissions to the hospital towards their end-of-life (EOL). Documentation of their resuscitation status should be a part of a broader dialogue with patients around their goals of care (GOC) and advance care planning (ACP), but rarely is this the case.

The innovation will involve the use of trained nurse facilitators to have meaningful conversations with patients and their families in an effective way that bridges the gap between resuscitation status, GOC discussions and ACP across the continuum of care.


Clinical Trial Description

1. On admission, the usual LHSC process will be followed whereby the patient's wishes for resuscitation are documented on the resuscitation record in the patient's chart. This constitutes the "original" resuscitation status.

2. After referral or screening and written consent, the RA will conduct semi-structured, face-to-face interviews with the patient and or SDM as appropriate. If the RA has concern about a discordance, he/she will then provide verbal feedback to the health-care team (Attending Physician or the Senior Medical Resident (SMR)) immediately and request them to communicate with the patient/SDM again. A case of discordance shall be recorded ONLY if the health-care team (Attending Physician or Senior Medical Resident) confirms that a change in resuscitation status is needed. The output of this intervention will be the "revised" resuscitation status. This "standardized" process for determining this outcome has worked well in our pilot study. Any disagreements between RA and SMR on patient/SDM preferences will be reported to Team#1 Attending and recorded. It will be up to the team to reconcile the "revised" resuscitation preferences on official records (Resuscitation status can only be filled in only by an MD as per hospital policy).

4. Advanced Clinical Notes: These will be typed by the RA and a note be made of the "revised" resuscitation preferences along with GOC and ACP discussions.

5. A pilot study related to this work started in August 2016 and has allowed the research team to evaluate barriers and facilitators of conducting this intervention on Internal Medicine patients. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03297320
Study type Interventional
Source Lawson Health Research Institute
Contact Launa Elliott, BSc
Phone 519 685-8500
Email Ravi.Taneja@lhsc.on.ca
Status Recruiting
Phase N/A
Start date January 1, 2017
Completion date March 31, 2019

See also
  Status Clinical Trial Phase
Not yet recruiting NCT06035549 - Resilience in East Asian Immigrants for Advance Care Planning Discussions N/A
Completed NCT02797444 - Advance Care Planning for Critical Care - A Prelude to Breaking Barriers N/A
Completed NCT01933789 - Improving Communication About Serious Illness N/A
Completed NCT05046197 - Evaluating the Integration of the Recommended Summary Plan for Emergency Care Treatment (ReSPECT) Into Primary Care
Not yet recruiting NCT06247215 - Development of a Culturally Tailored Resilience-building Intervention for Chinese American's Advance Care Planning Discussions N/A
Not yet recruiting NCT06061965 - Facilitating Advance Care Planning Discussions for People With Advance Cancer N/A
Active, not recruiting NCT06061107 - Effects of Intervention on Hope, Anxiety, and Attitudes and Behavioral Intentions of Advance Care Planning in Older Adults With Cancer N/A
Completed NCT04857060 - Palliative Care Educator N/A
Active, not recruiting NCT04012749 - UC Health Care Planning Study N/A
Terminated NCT03229811 - Integrating Conservative Kidney Management Options and Advance Care Planning Into a Pre-Dialysis Educational Program N/A
Completed NCT01391429 - Testing a Video Decision Support Tool to Supplement Goals-of-Care Discussions N/A
Recruiting NCT06090240 - Motivational Interviewing to Enhance Advance Care Planning for Older Adults and Caregivers After Emergency Visits N/A
Recruiting NCT05681585 - Advanced Care Planning for the Severely Ill Home-dwelling Elderly N/A
Recruiting NCT06350968 - Implementation of Online Advance Care Planning Tool for (Hemato-)Oncological Patients Within the Cancer Network Concord
Suspended NCT04065685 - A Nurse-led Patient-centred Intervention to Increase Written Advance Directives N/A
Completed NCT03958552 - Palliative Care Consultations in the Skilled Nursing Facility (SNF) Setting N/A
Completed NCT03251976 - CPR Decision Aid For Patients With Advanced Gynecologic Malignancies N/A
Completed NCT04296136 - Quality Improvement Project for Advance Care Planning Tool in Hospital Medicine
Not yet recruiting NCT06090734 - Development and Evaluation of 'My Voice': A Randomized Controlled Trial N/A
Completed NCT03609658 - Integrated Multidisciplinary Patient and Family Advance Care Planning Trial N/A