[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"trial:NCT06596577":3,"trial-entities:NCT06596577":162,"trial-summary:NCT06596577":165},{"id":4,"nct_id":4,"org_study_id":5,"brief_title":6,"official_title":7,"overall_status":8,"completion_date":9,"status_verified_date":10,"last_update_date":11,"start_date":12,"sponsor_name":13,"lead_sponsor_class":14,"has_dmc":15,"brief_summary":16,"detailed_description":17,"conditions":18,"keywords":21,"study_type":24,"primary_purpose":25,"phases":26,"enrollment_info":28,"interventions":31,"primary_outcomes":45,"secondary_outcomes":50,"sex":88,"minimum_age":89,"maximum_age":17,"healthy_volunteers":90,"eligibility_criteria":91,"std_ages":95,"locations":98,"central_contacts":153,"overall_officials":154,"references":160,"see_also_links":161},"NCT06596577","856359","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","ENROLLING_BY_INVITATION","2029-02-28","2025-09","2026-04-30","2025-08-06","University of Pennsylvania","OTHER",true,"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.",null,[19,20],"Serious Illness","Palliative",[22,23],"Palliative Care","Pragmatic Trial","INTERVENTIONAL","HEALTH_SERVICES_RESEARCH",[27],"PHASE3",{"count":29,"type":30},18000,"ESTIMATED",[32,40],{"type":33,"name":34,"description":35,"armGroupLabels":36,"otherNames":38},"BEHAVIORAL","Palliative care needs information","clinician-directed EHR alert providing information about serious illness diagnosis(-es) and unmet palliative care needs",[37],"Palliative care needs information provision",[39],"PC needs information",{"type":33,"name":41,"description":42,"armGroupLabels":43},"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",[44],"Palliative care needs information provision + default consult order",[46],{"measure":47,"description":48,"timeFrame":49},"Inpatient palliative care consultation","Binary: at least 1 inpatient visit from a PC specialist during the hospital encounter","from enrollment up to 26 weeks",[51,55,58,61,65,69,72,76,79,82,85],{"measure":52,"description":53,"timeFrame":54},"Hospice enrollment","Binary: hospice enrollment (any level of service)","enrollment through 6 months",{"measure":56,"description":57,"timeFrame":54},"Hospice duration","Continuous: total days enrolled in hospice (any level of service)",{"measure":59,"description":60,"timeFrame":54},"Community palliative care referral","Binary: order for community (home or outpatient clinic) palliative care consultation",{"measure":62,"description":63,"timeFrame":64},"Hospital all-cause mortality","Binary: (primary definition) death in the hospital; (secondary\u002Fsensitivity definition) death in the hospital or within 1 calendar day of discharge day.","enrollment to 1 day after hospital discharge",{"measure":66,"description":67,"timeFrame":68},"30-day hospital readmission","Binary: date of admission to an acute care hospital is within 30 days of hospital discharge","hospital discharge through 30 days",{"measure":70,"description":71,"timeFrame":54},"Number of readmissions","Count: number of acute care hospital admissions",{"measure":73,"description":74,"timeFrame":75},"Hospital-free days","Count: days from enrollment spent alive and not in an acute care hospital through 6 months or death","Enrollment through 6 months",{"measure":77,"description":78,"timeFrame":49},"Change in code status","Binary; any change in code status order at enrollment and code status order at hospital discharge",{"measure":80,"description":81,"timeFrame":49},"Time to palliative care consult","Continuous (hours): enrollment to documentation timestamp of first inpatient palliative care consult",{"measure":83,"description":84,"timeFrame":49},"Discharge to hospice","Binary: (primary definition) hospital discharge disposition to hospice (any location or level of service); (secondary\u002Fsensitivity analysis definition) hospital discharge disposition to hospice or comfort-focused care orders in-hospital",{"measure":86,"description":87,"timeFrame":49},"Hospital length of stay","Continuous: enrollment time to hospital discharge order timestamp.","ALL","18 Years",false,{"inclusion":92,"exclusion":93,"raw_text":94},[],[],"Inclusion Criteria:\n\n1. Age 18 years or older; AND\n2. Admitted to inpatient status at 1 of the 9 participating hospitals\n3. Meets validated score threshold of 8 from the MedStar unmet PC needs patient identification algorithm, utilizing empirically-derived weights for each PC need domain within the algorithm.\n\nExclusion Criteria:\n\n1. Primary inpatient service: hospice, rehabilitation, psychiatry, obstetrics, neonatal\n2. Signed hospital discharge order",[96,97],"ADULT","OLDER_ADULT",[99,108,112,120,124,128,132,139,146],{"facility":100,"city":101,"state":102,"zip":103,"country":104,"geoPoint":105},"MedStar Georgetown University Hospital","Washington D.C.","District of Columbia","20007","United States",{"lat":106,"lon":107},38.89511,-77.03637,{"facility":109,"city":101,"state":102,"zip":110,"country":104,"geoPoint":111},"MedStar Washington Health Center","20010",{"lat":106,"lon":107},{"facility":113,"city":114,"state":115,"zip":116,"country":104,"geoPoint":117},"MedStar Union Memorial Hospital","Baltimore","Maryland","21218",{"lat":118,"lon":119},39.29038,-76.61219,{"facility":121,"city":114,"state":115,"zip":122,"country":104,"geoPoint":123},"MedStar Harbor Hospital","21225",{"lat":118,"lon":119},{"facility":125,"city":114,"state":115,"zip":126,"country":104,"geoPoint":127},"MedStar Franklin Square Medical Center","21237",{"lat":118,"lon":119},{"facility":129,"city":114,"state":115,"zip":130,"country":104,"geoPoint":131},"MedStar Good Samaritan Hospital","21239 ·",{"lat":118,"lon":119},{"facility":133,"city":134,"state":115,"zip":135,"country":104,"geoPoint":136},"MedStar Southern Maryland Hospital Center","Clinton","20735",{"lat":137,"lon":138},38.76511,-76.89831,{"facility":140,"city":141,"state":115,"zip":142,"country":104,"geoPoint":143},"MedStar St. Mary's Hospital","Leonardtown","20650",{"lat":144,"lon":145},38.29124,-76.63579,{"facility":147,"city":148,"state":115,"zip":149,"country":104,"geoPoint":150},"MedStar Montgomery Medical Center","Olney","20832",{"lat":151,"lon":152},39.15316,-77.06692,[],[155,158],{"name":156,"affiliation":13,"role":157},"Katherine Courtright, MD, MS","PRINCIPAL_INVESTIGATOR",{"name":159,"affiliation":13,"role":157},"Michael Harhay, PhD, MPH",[],[],{"nct_id":4,"conditions":163,"biomarkers":164},[19],[],{"nct_id":4,"found":90,"summary":17,"prompt_version":17}]