Recruiting

Palliative Care

Sponsor:

Washington University School of Medicine

Code:

NCT06574672

Conditions

Critical Illness

End of Life

Quality of Life

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Interventions

Embedded Hospice and Palliative Care Practitioner

Embedded Hospice and Palliative Care Practitioner (Group Effect)

None (Historical)

Study Details

Brief summary:

The goal of this study is to investigate whether embedding a hospice and palliative care practitioner within a medical intensive care unit will improve patient outcomes and healthcare usage. The practitioner will work solely within the medical intensive care units and offer timely as well as proactive consultations based on clinical criteria and estimated mortality risk. The study team will compare patients seen by the practitioner to patients in an adjacent ICU and historical patients to determine whether patient care is improved by this intervention.

Conditions

Critical Illness

End of Life

Quality of Life

Study ID

NCT06574672

Start date

Jul 29, 2024

Status verified date

Jul, 2025

Completion date

Jun, 2027

Anticipated

Primary completion date

Jun, 2026

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Patients admitted to the medical intensive care units at a tertiary referral center
  • Patients must be at least 18 years of age

Exclusion Criteria:

  • None

Study Design

Enrollment

2600 participants

Anticipated

Allocation

Randomized

Intervention Model

Sequential

Primary purpose

Supportive Care

Interventions and Outcome Measures

Arms

experimental: Prospective Hospice and Palliative Care Intervention

This arm comprises patients admitted to the specific medical intensive care unit in which the hospice and palliative care practitioner is currently active. This will include all patients admitted to a single medical intensive care unit during the anticipated first half of the intervention timeframe, followed by all patients admitted to both medical intensive care units during the second half of the intervention timeframe.

active comparator: Prospective Standard of Care

This arm comprises patients admitted to the medical intensive care unit in which the hospice and palliative care practitioner is not currently active, but which may experience a group effect due to the study's ongoing enrollment and the practitioner's presence. This will include all patients admitted to a single medical intensive care unit during the anticipated first half of the intervention timeframe, prior to the practitioner becoming active in both intensive care units.

placebo comparator: Historical Controls

This arm comprises historical patients admitted to the medical intensive care units in the year prior to study enrollment.

Interventions

Embedded Hospice and Palliative Care Practitioner

The hospice and palliative care practitioner will be embedded in one medical intensive care unit for the first half of the study timeframe, after which the practitioner will expand to both medical intensive care units. While active in a medical intensive care unit, the practitioner will proactively trigger palliative care consultations based on clinical criteria and estimated mortality risk, in addition to providing immediate availability for standard-of-care hospice or palliative care consultations.

Embedded Hospice and Palliative Care Practitioner (Group Effect)

While the hospice and palliative care practitioner is active in one medical intensive care unit with respect to triggering consultations, the other medical intensive care unit can still utilize the practitioner's services for standard-of-care hospice or palliative care consultations.

None (Historical)

This control arm includes historical patients admitted to the medical intensive care units prior to the study's enrollment timeframe.

Primary outcome measure

  • ICU Length of Stay [ Time Frame: From date of enrollment until hospital discharge, assessed up to 1 year ]
  • Code Status De-escalation [ Time Frame: From date of enrollment until hospital discharge, assessed up to 1 year ]

Central Contacts and Locations

Central contacts

Stephen Chi, MD

314-273-6176chis@wustl.edu

Locations

Barnes Jewish Hospital

Recruiting

St Louis, Missouri, United States, 63110

Contacts

Stephen Chi, MD

314-273-6176chis@wustl.edu

Principal Investigator:

Stephen Chi, MD

More Information

Sponsor

Washington University School of Medicine

Last update posted

Jul 16, 2025

Last verified

Jul, 2025

Keywords

  • Palliative Care
  • Hospice
  • Medical ICU

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by Washington University School of Medicine on 2025-07-16.