Aim: This study aimed to evaluate the feasibility, effectiveness, and acceptability of an intensive care unit (ICU) orientation intervention to improve advance care planning among patients with hematologic malignancies.
Study Design: This prospective observational cohort study enrolled high-risk hospitalized patients with hematologic malignancies who had a directive for full resuscitative measures. The intervention consisted of a: (1) video outlining ICU interventions and outcomes; (2) a values and preferences workbook; and (3) a follow-up meeting to discuss goals of care. Feasibility outcomes included recruitment and completion rates for each study component. Effectiveness was assessed using pre- and post-video surveys measuring knowledge of ICU interventions and outcomes. Acceptability was evaluated using an emotional impact survey and the proportion of participants who chose to terminate the video prematurely.
Results: Fifteen participants were recruited. Regarding feasibility, 11 of 15 participants (73%) completed all study components. All participants (15/15) completed the video, and 13 of 15 (87%) completed the follow-up meeting. Regarding effectiveness, the proportion of participants achieving a score of 90% or higher increased from the 8% (1/12) on the pre-video survey to 58% (7/12) on the post-video survey. Regarding acceptability, no participants terminated the video prematurely. Most participants reported being glad to have had the opportunity to discuss ICU-level care (11/12, 92%) and stated that they would recommend the video to others (10/12, 83%).
Conclusions: This pilot study provides important data to inform the development of a larger evaluation of an ICU orientation initiative aimed at promoting goal-concordant care in the event of critical illness.