Facilitating Communication Study (FCS2)
Principal Investigators: JR Curtis, RA Engelberg
Research Grant: National Institute of Nursing Research (NINR), October 2018 to September 2023
This randomized trial evaluates the intervention of a novel nurse “facilitator” trained to enhance communication between clinicians, patients and their families through transitions among health care teams and settings with the goal of defining, communicating, and delivering care that is consistent with the goals of informed patients and families.
Facilitators work with seriously ill patients and their families beginning with a critical care unit stay and following them over the course of 3 months. The intervention’s effectiveness is measured with patient- and family-centered outcomes and assessments of goal-concordant care, using follow-up questionnaires. The primary outcome is the family members’ burden of symptoms of depression over 6 months. We also evaluate whether the intervention improves the value of healthcare by reducing healthcare costs while improving patient and family outcomes. Finally, we use qualitative methods to explore implementation factors associated with improved implementation outcomes (acceptability, fidelity, penetration) to inform dissemination of this type of intervention to support patients and their families.
FCS2 at clinicaltrials.gov: https://clinicaltrials.gov/ct2/show/NCT03721952
ADRD Supplement
Principal Investigators: JR Curtis, RA Engelberg
Supplemental Research Grant: National Institute on Aging (NIA), September 2019 to August 2020
In 2019, we added a supplement to this study to explore factors that influence decision-making regarding the receipt of ICU care for patients with Alzheimer’s disease and related dementias (ADRD). Our aims are to: identify modifiable patient, family and clinician factors that influence decisions leading to the receipt of ICU care for patients with ADRD using semi-structured in-depth interviews with diverse stakeholders; and to identify modifiable systems-level factors that influence the decisions leading to the receipt of ICU care for patients with ADRD.
Publications from these studies include:
Curtis JR, Kentish-Barnes N, Brumback LC, Nielsen EL, Pollak KI, Treece PD, Hudson L, Garzio G, Im J, Weiner BJ, Khandelwal N, Resche-Rigon M, Azoulay E, Engelberg RA. Facilitating communication for critically ill patients and their family members: Study protocol for two randomized trials implemented in the U.S. and France. Contemp Clin Trials. 2021 Aug;107:106465. Epub 2021 Jun 3.
Dzeng E, Batten JN, Dohan D, Blythe J, Ritchie CS, Curtis JR. Hospital Culture and Intensity of End-of-Life Care at 3 Academic Medical Centers. JAMA Intern Med. 2023 Aug 1;183(8):839-848.