3 Wishes Project for End-of-Life Care

Recruiting at 3 trial locations

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Under 18, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 9

900 Participants Needed

Trial Summary

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the 3 Wishes Project treatment for end-of-life care?

The 3 Wishes Project helps improve end-of-life care by making the experience more meaningful for patients and their families, and it positively impacts the healthcare team. Clinicians have observed that it fosters better connections and eases family grief, which suggests its effectiveness in enhancing the quality of care in the ICU. ^{1 2 3 4 5}

How does the 3 Wishes Project treatment differ from other end-of-life care treatments?

The 3 Wishes Project is unique because it focuses on honoring the dignity of dying patients by creating personalized and meaningful experiences for them and their families, rather than providing medical interventions. It involves eliciting and implementing final wishes to foster human connections and ease family grief, which is different from traditional end-of-life care that often centers on medical management. ^{2 3 4 6 7}

What is the purpose of this trial?

Dignified and compassionate end-of-life (EOL) care is a cornerstone of high-quality, patient-centered care, but in safety-net hospitals EOL care is often overlooked, considered too late, or not at all. By eliciting and implementing final wishes for dying patients, the 3 Wishes Project (3WP) has demonstrated, in tertiary academic centers, that acts of compassion can improve the EOL experience and help families cope with loss. The investigators propose to implement the 3WP in safety-net hospitals where there are less resources and more diverse, disadvantaged patient populations, and hypothesize that there will be similar positive effects on the EOL experience for patients, families, and clinicians.

Eligibility Criteria

This trial is for patients at the end of their life in safety-net hospitals, which often serve diverse and disadvantaged populations. The goal is to improve the quality of end-of-life care by honoring final wishes.

Inclusion Criteria

For participation in the 3WP, if there was a decision to withdraw life support or the health care team agreed that the patient's probability of dying in the hospital or on discharge to hospice was >95%

For surveys, next of kin/surrogate of a patient who died in the ICU during the study period

Exclusion Criteria

I am under 18 years old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Implementation

Implementation of the 3 Wishes Project in safety-net hospitals to improve end-of-life care

6 months

Evaluation

Evaluation of the quality of end-of-life ICU care, bereaved families' psychological symptoms, and clinician burnout

3 months

Surveys conducted 3 months after patient's death

Follow-up

Monitoring of nurse burnout and effectiveness of the 3 Wishes Project

1 year

Surveys conducted at 6 months and 1 year after implementation

Treatment Details

Interventions

• 3 Wishes Project

Trial Overview The '3 Wishes Project' (3WP) aims to enhance dignity in dying by implementing personalized gestures of compassion. This study tests if 3WP can positively impact end-of-life experiences in resource-limited hospitals.

Participant Groups

Group I: 3WP intervention Experimental Treatment 1 Intervention

families of patients whose loved ones died in the ICU where the 3 Wishes Program has been implemented

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

LAC+USC Medical Center

Collaborator

Trials

13

Recruited

31,400+

Olive View-UCLA Education & Research Institute

Collaborator

Trials

34

Recruited

880,000+

Findings from Research

The 3 Wishes Project (3WP) was successfully implemented in an oncology ward, where it facilitated the fulfillment of 175 final wishes for 52 cancer patients, significantly enhancing the end-of-life experience for both patients and their families.

Qualitative interviews with family members indicated that the 3WP helped ease transitions during the end-of-life process, allowing families to shift from a caregiver role to a more personal connection and focus on creating lasting legacies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

End-of-life transitions for family member on the solid tumour oncology ward: the 3 Wishes Project. Day, G., Bear, D., Swinton, M., et al.[2021]

References

1. England pubmed.ncbi.nlm.nih.gov

Initiating and integrating a personalized end of life care project in a community hospital intensive care unit: A qualitative study of clinician and implementation team perspectives. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Expanding the 3 Wishes Project for compassionate end-of-life care: a qualitative evaluation of local adaptations. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Building organizational compassion among teams delivering end-of-life care in the intensive care unit: The 3 Wishes Project. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Compassionate End-of-Life Care: Mixed-Methods Multisite Evaluation of the 3 Wishes Project. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Improving End-of-Life Care in the Intensive Care Unit: Clinicians' Experiences with the 3 Wishes Project. [2020]

6. Canada pubmed.ncbi.nlm.nih.gov

Community implementation of the 3 Wishes Project: an observational study of a compassionate end-of-life care initiative for critically ill patients. [2021]

7. England pubmed.ncbi.nlm.nih.gov

End-of-life transitions for family member on the solid tumour oncology ward: the 3 Wishes Project. [2021]