NCT06596577

Nudging Effective and Equitable Delivery of Specialty Palliative Care

Improving the Delivery and Equity of Inpatient Palliative Care: a Hybrid Type I Pragmatic Cluster Trial

• Status: Enrolling By Invitation
• Phase: Phase 3
• Study type: Interventional
• Enrollment: 18,000 (estimated)
• Sponsor: University of Pennsylvania · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

This stepped-wedge, cluster randomized pragmatic trial among 9 MedStar hospitals for patients with serious illness and unmet palliative care (PC) needs will test two interventions embedded within the electronic health record (EHR): (1) a PC needs triggered alert to opt-in to PC consults nudging hospital clinicians to order specialty PC consults for eligible inpatients, and (2) a palliative care needs triggered alert with an opt-out to palliative care consults. The trial will compare the interventions effects to usual care, focusing on completed PC consults during the hospital encounter and other secondary outcomes. The trial also includes an embedded mixed methods study to explore factors influencing the effectiveness and equity of intervention implementation.

Conditions

• Serious Illness
• Palliative

Interventions

Type	Name	Description
BEHAVIORAL	Palliative care needs information	clinician-directed EHR alert providing information about serious illness diagnosis(-es) and unmet palliative care needs
BEHAVIORAL	Default consult order	clinician-directed EHR alert providing information about serious illness diagnosis(-es) and unmet palliative care needs + a choice to cancel the default palliative care consult order

Timeline

• Start date: 2025-08-06
• Primary completion: 2028-03-01
• Completion: 2029-02-28
• First posted: 2024-09-19
• Last updated: 2026-02-17

Locations

9 sites across 1 country: United States