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CommunicationNCT02333396

Improving Communication in the PICU: The Navigate Study

A study testing PICU Supports and Educational Brochure in people with Communication, run by Ann & Robert H Lurie Children's Hospital of Chicago at 2 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The project seeks to study the use of an navigator-based intervention called "PICU Supports." The study will test the impact of PICU Supports during and after PICU discharge on parent outcomes (satisfaction with decision making, decision regret, anxiety, depression, post-traumatic stress, health-related quality of… Read more about this study

Who is it for?
Any age
Conditions the study is for
Communication
What is being tested?
PICU Supports and Educational Brochure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
442 participants
Where
2 sitesUnited States
Study dates
6 Apr 2015to 28 Apr 2017
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Case Patients
  • patients < 18 years of age admitted to the PICU
  • parents are English or Spanish-speakers and who:
  • are likely to require PICU care for at least 24 hours (as determined by the PICU attending physician) or
  • have a Pediatric Index of Mortality 2 (PIM2) score ≥ 4% (a PIM2 score predicts risk of mortality based on clinical data collected at the time of admission to the PICU)
  • Case patients will be included in the study if one of his/her parents agrees to participate in the study and signs a written consent form.
Show all 15Show fewer
  • Parents of case patients
  • Parent of an eligible case patient.
  • PICU attending gives permission to approach the parent about the study.
  • Parent is an English or Spanish speaker.
  • Parent provides written consent for participation.
  • Healthcare Team Members for the pre-post assessment of team communication and focus group:
  • -This group will include as many clinicians in the following groups as possible (identified by the site principal investigator): PICU physicians (attendings and fellows); PICU bedside nurses; PICU Advance Practice Nurses (APNs); hospitalists; subspecialty physicians who consult on PICU patients; subspecialty APNs who consult on PICU patients; PICU respiratory therapist; PICU physical/occupational/speech therapists; and social workers (SWs), chaplains, and case managers who follow PICU patients.
  • Healthcare team members for the written feedback/assessment of the intervention:
  • -HTMs caring for the case patient at the time of PICU discharge: (PICU attending; PICU fellow; social worker (if involved); chaplain (if involved); bedside nurse; PICU resident, APN or hospitalist; and one to two subspecialty attendings)

Who cannot join

  • PICU attending does not give permission to approach the parent about the study.
  • Parent is not an English or Spanish speaker.
  • Parent does not provide written consent to participate.
  • The case patient does not provide assent (if able to provide assent).
  • -Healthcare team member that does not regularly care for patients in the PICU.

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Ann & Robert H. Lurie Children's Hospital of Chicago

    Chicago, Illinois, 60611

  • The University of Chicago Medicine Comer Children's Hospital

    Chicago, Illinois, 60637

Other trials in United States

About this study

Official title: Improving Communication in the Pediatric Intensive Care Unit for Patients Facing Life-Changing Decisions: The Navigate Study

The project seeks to study the use of an navigator-based intervention called "PICU Supports." The study will test the impact of PICU Supports during and after PICU discharge on parent outcomes (satisfaction with decision making, decision regret, anxiety, depression, post-traumatic stress, health-related quality of life, and complicated bereavement) and on parent and healthcare team member assessments of communication and team collaboration.

Read the detailed description

Parents of children admitted to the PICU often face challenging decisions. Research demonstrates deficiencies in communication in the PICU which could impact decision making. This study team has developed a navigator-based intervention call PICU Supports. PICU Supports aims to provide the following types of support to parents of patients in the PICU: emotional; communication (between healthcare team members and parents/families as well as among healthcare team members ); decision making; transitions out of the PICU (i.e. discharge transitions to a non-PICU hospital bed, a long term care facility, or home); and information. Support is accomplished by navigator engagement with parents and healthcare team members and the guided use of navigator supported ancillary tools provided to parents and healthcare team members as needed. During the patient's PICU stay, the navigator activities and use of ancillary tools is directed by the family's needs. Thus PICU Supports uses a predefined framework of activities and tools to provide individualized support directed by the needs of the parent and the patient situation. This research will test PICU Supports in the clinical setting. This will be accomplished by conducting a pilot study of PICU Supports at Ann \& Robert H. Lurie Children's Hospital of Chicago (Lurie Children's Hospital), followed by a randomized controlled trial (RCT) comparing the intervention, PICU Supports, to a control, parental receipt of an educational brochure. The RCT will be conducted at Lurie Children's Hospital and at University of Chicago Medicine Comer Children's Hospital (Comer Children's Hospital).

Conditions
Communication
Being tested
PICU Supports, Educational Brochure
Keywords
Navigator, Intervention Study, Randomized Controlled Trial, Pediatric Intensive Care Unit, Decision Making
Medical subject headings
Communication

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PICU SupportsOther

    The PICU Supports intervention includes navigator activities and ancillary tools. The Navigator activities include: initial visits with the healthcare team members (HTMs) and parents; weekday visits with the parents and feedback to the HTMs as needed; coordination of weekly family meetings between the parents and HTMs; and support during transitions out of the unit. The ancillary tools include: a PICU handbook; a place for parents to keep track of events and their goals; a provider sheet to inform PICU HTMs about important parental issues, concerns or goals; a bedside communication log so parents know which non-PICU HTMs have visited; an end-of-life checklist; a bereavement packet for those whose child dies; and informational resources.

  • Educational BrochureOther

    Parents will receive a short educational brochure with information about the pediatric intensive care unit.

Study groups in NCT02333396
Study groupRoleWhat they receive
PICU SupportsExperimentalParticipants will receive the PICU Supports intervention.
Receives: Other: PICU Supports
Educational BrochureActive comparatorParticipants will receive an educational brochure about the pediatric intensive care unit.
Receives: Other: Educational Brochure

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Satisfaction With Decision Making (Percentage of "Excellent" Scores in the Decision Making Domain of the Pediatric Family Satisfaction in the Intensive Care Unit (pFS-ICU) Questionnaire)

    Percentage of "excellent" scores in the decision making domain of the Pediatric Family Satisfaction in the Intensive Care Unit (pFS-ICU) questionnaire; minimum=0, maximum=100, higher score is better outcome

    Measured: 3-5 weeks following PICU discharge

Secondary outcomes (13)
  1. Pediatric Family Decision Making Satisfaction in the Intensive Care Unit (pFS-ICU)

    Measures satisfaction of family who have a child admitted to the Pediatric intensive care unit; Pediatric Family Satisfaction in the Intensive Care Unit (pFS-ICU) questionnaire mean score, range 0-100, higher score is the better outcome

    Measured: 3-5 weeks following PICU discharge

  2. Parental Satisfaction in the PICU (Score on the Pediatric Family Satisfaction in the Intensive Care Unit (pFS-ICU) Questionnaire)

    Subscale: Satisfaction with Care Score on the Pediatric Family Satisfaction in the Intensive Care Unit (pFS-ICU) questionnaire; minimum=0, maximum=100, higher score is better outcome

    Measured: 3-5 weeks after PICU Discharge

  3. Parental Satisfaction in the PICU (Score on the Pediatric Family Satisfaction in the Intensive Care Unit (pFS-ICU) Questionnaire)

    Subscale: Satisfaction with Decision Making Score on the Pediatric Family Satisfaction in the Intensive Care Unit (pFS-ICU) questionnaire; minimum=0, maximum=100, higher score is better outcome

    Measured: 3-5 weeks after PICU Discharge

  4. Parental Decision Regret (Decision Regret Scale)

    Score on the Decision Regret Scale, a 5-item Likert-scale measure of decision regret; minimum=0, maximum=100; higher score indicates more decision regret

    Measured: 3-5 weeks after PICU discharge

  5. Parental Anxiety (Anxiety SF8a)

    Score on the Anxiety Short Form8a, a 8-item Likert-scale measure of anxiety, the higher the score, the worst the anxiety, T-score range of 37.1 - 83.1.

    A T score of 50 is the average fro the US general population. The SD is 10 with a T-score of 60 being 10 worse than the average and a T-score of 40 being 10 better than the average.

    Measured: 3-5 weeks after PICU discharge

  6. Parental Depression (Depression SF8a)

    Score on the Depression; Depression Short Form 8a, a 8-item Likert-scale measure of depression; the higher the score, the worst the depression, T-score range of 38.2 - 81.3.

    A T score of 50 is the average fro the US general population. The SD is 10 with a T-score of 60 being 10 worse than the average and a T-score of 40 being 10 better than the average.

    Measured: 3-5 weeks after PICU discharge

  7. Parental Impact of Event/Post-Traumatic Distress (Impact of Event Scale-revised)

    A measure of post-traumatic distress; Score on the Impact of Event Scale-revised, a 22-item Likert-scale measure of post-traumatic distress; scale range from 0 - 88; higher numbers mean higher trauma or distress; units on a scale

    Measured: 3-5 weeks after PICU discharge

  8. Parental Health-related Quality of Life (Global Health Scale) Physical

    Measure of global physical health; Physical - Score on the Global Health scale, a 10 item Likert-scale measure of overall health-related quality of life; the higher the score the worse global health, t-score range of 16.2 - 67.7.

    A T score of 50 is the average fro the US general population. The SD is 10 with a T-score of 60 being 10 worse than the average and a T-score of 40 being 10 better than the average.

    Measured: 3-5 weeks after PICU discharge

  9. Parental Health-related Quality of Life (Global Health Scale) Mental

    Measure of Global Mental Health; Mental - Score on the Global Health scale, a 10 item Likert-scale measure of overall health-related quality of life; high scores indicate worse mental health; T-score range 21.1 - 67.6.

    A T score of 50 is the average fro the US general population. The SD is 10 with a T-score of 60 being 10 worse than the average and a T-score of 40 being 10 better than the average.

    Measured: 3-5 weeks after PICU discharge

  10. Parental Complicated Bereavement (Grief Scale)

    Measure of complicated grief in parents after their child's death; Score on the Index of complicated Grief Scale, a 19-item Likert-scale measure of complicated grief; minimum 0, maximum 74; higher numbers mean more complicate grief

    Measured: 3-5 weeks after PICU discharge

  11. Parent Report of Healthcare Team Satisfaction (Collaboration and Satisfaction About Care Decisions Scale)

    Measure of Satisfaction with Healthcare team collaboaration Subscale Collaboration Satisfaction Score of the Collaboration and Satisfaction about Care Decisions scale, 2 items on a 9-item Likert-scale measure of healthcare team communication satisfaction in ICUs, Score range from 2 - 14 with higher numbers meaning more satisfaction

    Measured: 3-5 weeks after PICU Discharge

  12. Parent Report of Healthcare Team Collaboration (Collaboration and Satisfaction About Care Decisions Scale)

    Subscale Collaboration Score of the Collaboration and Satisfaction about Care Decisions scale, 7 items on a a 9-item Likert-scale measure of healthcare team communication in ICUs, scale range from 7 - 49. Higher numbers more collaboration.

    Measured: 3-5 weeks after PICU Discharge

  13. Parental Report of Acceptability and Perceived Effectiveness of PICU Supports (Likert-scale)

    Likert-scale items measuring perceived effectiveness and acceptability of the PICU Supports intervention.

    One likert scale item based on previous work. White DB, Cua SM, Walk R, et al. Nurse-led intervention to improve surrogate decision making for patients with advanced critical illness. Am J Crit Care. Nov 2012;21(6):396-409.

    How well did the PICU Supports help with communication in the PICU? scale "Not at all helpful" "Not very helpful" "Somewhat helpful" "Extremely Helpful" "Unable to assess" Scored based on percentage of participants who responded "Somewhat Helpful" or Extremely Helpful"

    Measured: 3-5 weeks after PICU Discharge

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Jan 2015 (estimated)
  2. Study start6 Apr 2015
  3. Primary completion28 Apr 2017
  4. Study completion28 Apr 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
442 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02333396
Sponsor's protocol ID
The Navigate Study
Status last verified
Mar 2025
First submitted
2 Jan 2015
Last updated
26 Mar 2025
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Ashworth RC, Malone JR, Franklin D, Sorce LR, Clayman ML, Frader J, White DB, Michelson KN. Associations of Patient and Parent Characteristics With Parental Decision Regret in the PICU: A Secondary Analysis of the 2015-2017 Navigate Randomized Comparative Trial. Pediatr Crit Care Med. 2024 Sep 1;25(9):795-803. doi: 10.1097/PCC.0000000000003534. Epub 2024 May 10.

    PubMed 38727516
  • Tager JB, Hinojosa JT, LiaBraaten BM, Balistreri KA, Aniciete D, Charleston E, Frader JE, White DB, Clayman ML, Sorce LR, Davies WH, Rothschild CB, Michelson KN; Navigate Study Investigators. Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset. Pediatr Crit Care Med. 2024 Feb 1;25(2):128-138. doi: 10.1097/PCC.0000000000003385. Epub 2023 Oct 27.

    PubMed 37889100

Questions about this trial

What is this clinical trial studying?

A study testing PICU Supports and Educational Brochure in people with Communication, run by Ann & Robert H Lurie Children's Hospital of Chicago at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Mar 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Satisfaction With Decision Making (Percentage of "Excellent" Scores in the Decision Making Domain of the Pediatric Family Satisfaction in the Intensive Care Unit (pFS-ICU) Questionnaire) (time frame: 3-5 weeks following PICU discharge). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02333396, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Mar 2025.

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