PICSI Pilot Study

Project to Improve Communication About Serious Illness – Pilot Study (PICSI-P)
Principal Investigator: JR Curtis
Research Grant: National Palliative Care Research Center (NPCRC)

This two-year pilot study tests whether a one-page “Jumpstart Form” affects goals-of-care discussions in the hospital. This form is provided to clinicians and includes patient-specific information about preferences for goals-of-care communication and for care, as well as tips to improve this communication. Jumpstart forms are also provided to patients or, if they are unable to communicate, their surrogate/family member. The information on the form is obtained from questionnaires. The form is tailored to help patients and surrogates talk with clinicians about goals of care. This study is based on a successful application of Jumpstart Form in the outpatient clinic setting.

Our purpose is to evaluate feasibility and acceptability of using the electronic health record (EHR) to identify eligible patients, and implement the “Jumpstart” intervention in the inpatient setting; evaluate the efficacy of the “Jumpstart” intervention for changing processes of care; and, to identify barriers and facilitators to Jumpstart’s implementation in future trials and clinical practice.

Publications related to this study include:

Lee RY, Kross EK, Downey L, Paul SR, Heywood J, Nielsen EL, Okimoto K, Brumback LC, Merel SE, Engelberg RA, Curtis JR. Efficacy of a Communication-Priming Intervention on Documented Goals-of-Care Discussions in Hospitalized Patients With Serious Illness: A Randomized Clinical Trial. JAMA Netw Open. 2022 Apr 1;5(4):e225088.

Abedini NC, Merel SE, Hicks KG, Torrence J, Heywood J, Engelberg RA, Kross EK, Curtis JR. Applying Human-Centered Design to Refinement of the Jumpstart Guide, a Clinician- and Patient-Facing Goals-of-Care Discussion Priming Tool. J Pain Symptom Manage. 2021 Dec;62(6):1283-1288. Epub 2021 Jun 18.