NCT02146573

Pediatric Continuity Care Intensivist

Pediatric Continuity Care Intensivist: Role Implementation and Randomized Control Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 276 (actual)
• Sponsor: Children's Hospital of Philadelphia · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Not accepted

Summary

This study will implement and evaluate the effects of a pediatric continuity care intensivist program. This study will determine the impact of an additional pediatric intensive care unit (PICU) intensivist on outcomes at the patient and family level. It will also evaluate the training program to prepare the continuity care intensivist (CCI).

Detailed description

This randomized controlled trial will implement and evaluate the effects of a pediatric continuity care intensivist (CCI) program. The study will evaluate how effective the modified communication training for providers is to perform this new role. The primary outcome for the study is whether a CCI will affect several patient level outcomes for patients who have been admitted to the PICU longer than 7 days. Patient length of stay, hospital acquired conditions, time to limitations of interventions and new medical technology will be assessed comparing the intervention and usual care arms. The study will also determine the impact of the CCI program on parent/family satisfaction with provider communication and decision-making for their child.

Conditions

• Critical Illness

Interventions

Type	Name	Description
BEHAVIORAL	Continuity Care Intensivist Communication Training	Physicians enrolled in the intervention arm will complete a two to three part communication training. Survey measures of communication competency and burnout will be administered at baseline, after training, and at the end of the study. After the communication training, physicians will undergo an OSCE assessment with a simulated patient to evaluate communication skills. At the end of the study, CCI providers will receive surveys that assess the experience and challenges of the role, repeat surveys assessing competency with communication and frequency of engaging families in goals of care conversations, in addition to a follow-up focus group that will assess their experience with the intervention, the time required and the potential tradeoffs in other duties required by them to participate as a CCI.
BEHAVIORAL	Continuity Care Intensivist (CCI) Provider Program	After undergoing CCI training, CCI providers will fulfill a standardized role with parent-patient dyads: * CCI will meet with families on a regular basis and at change of physician of record throughout their entire PICU hospitalization. * Help patients/families navigate decisions in concert with preferences and beliefs * Help patients/families and other care providers look at "bigger picture"; trajectory of illness, goals, and hopes for the patient. * Serve as point person for active intensivists on service and other specialists * Help resolve conflict when multiple providers have different opinions on course of action

Timeline

• Start date: 2014-05-01
• Primary completion: 2017-12-01
• Completion: 2018-12-01
• First posted: 2014-05-26
• Last updated: 2020-09-16

Locations

1 site across 1 country: United States