3 Wishes Project for End-of-Life Care

(WISHES Trial)

Not currently 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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve the end-of-life experience for patients in safety-net hospitals, which often have fewer resources and serve diverse, disadvantaged populations. It seeks to achieve this by implementing the 3 Wishes Project, a program that honors the final wishes of patients dying in intensive care units (ICUs). The goal is to provide compassionate care that makes the process more meaningful for both patients and their families. Families of patients in the ICU, where a decision has been made to withdraw life support or where the patient is not expected to survive the hospital stay, would be a good fit for this trial. Participants should be able to communicate in English or Spanish. As an unphased trial, this study offers a unique opportunity to contribute to compassionate care practices that can enhance the dignity and comfort of patients and their families.

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 prior data suggests that the 3 Wishes Project is safe for end-of-life care?

Research has shown that the 3 Wishes Project is well-received and safe. In one study, 99.2% of final wishes were granted for 101 patients nearing the end of life. This project emphasizes making patients' last moments meaningful, rather than focusing on medical treatments. Another study examined the project's impact on families and found positive experiences in intensive care units. The project offers a low-cost method to provide compassionate care. Overall, evidence suggests that the 3 Wishes Project is a safe and meaningful way to support patients and families during end-of-life care. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the 3 Wishes Project for end-of-life care because it offers a compassionate approach that focuses on fulfilling the dying wishes of patients in the ICU. Unlike traditional medical treatments that primarily aim to extend life or manage symptoms, this project enhances the quality of end-of-life experiences by personalizing care and creating meaningful memories for both patients and their families. This approach can provide emotional support and closure, making it a unique and potentially transformative addition to end-of-life care practices.

What evidence suggests that the 3 Wishes Project is effective for improving end-of-life care?

Research shows that the 3 Wishes Project (3WP), studied in this trial, makes end-of-life experiences more personal and caring. Studies have found that 3WP honors patients' final wishes, making the process more dignified and comfortable for both patients and their families. For instance, one study found that families coped better with loss when they celebrated a patient’s life through this program. The project also builds strong connections among patients, families, and healthcare providers by using palliative care practices, which focus on comfort and support for those who are dying. By emphasizing these personal touches, the 3WP may improve the overall experience during a difficult time. ^{1 2 4 6 7}

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

National Institute of Nursing Research (NINR)

Collaborator

Trials

623

Recruited

10,400,000+

Published Research Related to This Trial

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8313093/

Community implementation of the 3 Wishes Project The 3 Wishes Project (3WP) promotes a personalized dying experience by eliciting and facilitating individualized terminal wishes for patients, ...

2. aacnjournals.org aacnjournals.org/ajcconline/article/33/1/9/32267/Use-of-the-3-Wishes-Project-to-Help-Individualize

Use of the 3 Wishes Project to Help Individualize End-of-Life ... The 3 Wishes Project is an EOL intervention that provides direction for individualized care with 3 goals: dignify death, celebrate the patient's life, and ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05128799?term=AREA%5BConditionSearch%5D(%22Death%22)&rank=1

Effect of the 3 Wishes Program on Bereaved Families' End- ... This is a quality improvement study to evaluate the effect of the 3 Wishes Program (3WP) on end-of-life (EOL) care in the adult ICUs of a two-hospital academic ...

4. bmcpalliatcare.biomedcentral.com bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-020-00601-5

Expanding the 3 Wishes Project for compassionate end-of-life ... The 3 Wishes Project (3WP) is an end-of-life program that honors the dignity of dying patients by fostering meaningful connections among patients, families, ...

5. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/26167721/

Personalizing death in the intensive care unit: the 3 Wishes ... The 3 Wishes Project facilitated personalization of the dying process through explicit integration of palliative and spiritual care into critical care practice.

6. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0320843

Protocol for a hybrid effectiveness-implementation study The 3 Wishes Project (3WP) is a low-cost intervention that aims to enhance compassionate end-of-life (EOL) experiences by empowering the clinical team.

7. utppublishing.com utppublishing.com/doi/full/10.22374/cjgim.v16i3.506

3 Wishes Without Borders: Enhancing End of Life Care for ... Results. From January 2017 to March 2020, we enrolled 23 patients and elicited 117 wishes (mean five wishes/patient). Direct engagement in the wish ...