Training Training Module 2: Module 2: Respondent Respondent Eligibility Eligibility CriteriaCriteria

This training session This training session contains information contains information

regarding:regarding: Approaching Patients/Family Approaching Patients/Family

MembersMembers Inclusion CriteriaInclusion Criteria Exclusion CriteriaExclusion Criteria

Approaching Approaching Patients/Family Patients/Family

MembersMembers

Identifying Potentially Identifying Potentially Eligible Patient/Family Eligible Patient/Family

MembersMembers The local team should screen for eligible

patients/family members on the targeted units.

Potentially eligible patients may be identified by seeking input from: The attending physician Medical residents Nurses Other healthcare staff By reviewing the medical chart

Before Approaching the Before Approaching the Patient/Family Member:Patient/Family Member:

Confirm eligibility by reviewing the medical chart

Confirm ‘suitability’ of the patient/family member by discussing the case with a member of the health care teamBy suitability, we mean that the patient/family member has the physical/emotional stamina and cognitive capacity to participate in the questionnaire.

Identifying a Family Identifying a Family MemberMember

Study patients will be asked to identify, if applicable, a family member (or caregiver) who knows them the best who: Is greater than 18 years old; and Has visited the patient in hospital at least once;

and Who provides the most care to the patient and is

not paid to do so. If there is more than one family member

available, we will allow the patient to select who participates.

If the patient is too sick to identify a family member, the researcher should approach the clinical team or medical chart to see if there is a documented Power of Attorney or substitute decision maker. In the absence of such documentation, the

researcher may then approach the family. When approaching the family, the

appropriate individual will often identify themselves to the researcher as the appropriate family member respondent for the study.

Only one family member respondent can participate in the ACCEPT Study.

Timing of ApproachTiming of Approach

Time of initial approach of Time of initial approach of patient/family member:patient/family member:

Patients/family members should be Patients/family members should be approached for the study after the approached for the study after the patient has been in the hospital for patient has been in the hospital for at least 48 hours but before the at least 48 hours but before the 120th hour.120th hour.

Inclusion CriteriaInclusion Criteria

Inclusion CriteriaInclusion Criteria

55 years or 55 years or older with older with one or one or more of the more of the following following diagnoses: diagnoses:

Chronic obstructive lung disease

Congestive heart failure

Cirrhosis Cancer End-stage

dementia Renal failure

Any patient Any patient 80 years of 80 years of age or age or older older admitted to admitted to hospital hospital from the from the community community because of because of an acute an acute medical or medical or surgical surgical condition condition (and (and doesn’t doesn’t meet the meet the criteria to criteria to the left.)the left.)

OORR

Patients who are:

OORR

Any patient Any patient 55 to 79 55 to 79 years of age years of age admitted to admitted to the hospital, the hospital, who does not who does not meet the meet the above above criteria, but criteria, but in the in the opinion of a opinion of a health care health care team team member member (Doctor, (Doctor, resident, resident, nurse), nurse), he/she would he/she would not be not be surprised if surprised if the patient the patient died in 6 died in 6 months.months.

Correctly Documenting Correctly Documenting the Inclusion of the Inclusion of >> 80 80

year oldsyear olds For patients ≥80 years old, it is important

to, whenever possible, document the specific diagnosis present.

For example: If a patient is 82 years old with COPD, they should be entered into the CRS as meeting inclusion criteria 1 “55 years or older with one or more of the following diagnoses: COPD.”

For example: If a patient is 85 years old, admitted to the hospital with a UTI, since they do not meet any of the specific diagnoses in inclusion criteria #1, they should be logged as inclusion criteria #2 “Any patient 80 years of age or older admitted to hospital from the community because of an acute medical or surgical condition.”

COPD CriteriaCOPD Criteria It is often difficult to find forced expiratory

volume (FEV1) data in the medical chart. If the medical notes document "severe" COPD and/or air flow limitation and everything else about the condition confirms that (i.e. limited functional capacity, on home 02, frail, etc.), AND they meet one of the other formal inclusion criteria, this patient can be included in the study.

Don't exclude just because you can't find the FEV 1 data and yet they are severe COPD.

Exclusion Exclusion CriteriaCriteria

Exclusion CriteriaExclusion Criteria

Patient Family MemberNon-English/Non-French speaking patient 

Non-English/Non-French speaking family member

Cognitive impairment

Patient/Family Members who are Legally Blind

Patients and/or family members who are legally blind are eligible to participate in the study. When administering the ACP Questionnaire simply omit the REALM score (Section 1, Health Literacy) and try to get through the rest of the questionnaire.

Documenting ExclusionsDocumenting Exclusions

Reasons for exclusion of a patient and/or family member must be documented.

This data is used to help inform the site and coordinating centre of any barriers to enrollment.

It is important to be as specific as possible regarding the reason for exclusion. Use one of the specific drop-down options in the CRS rather than use “other.”

Types of RespondentsTypes of Respondents

PatientPatient

Family MemberFamily Member

Ideal scenario = Patient + Family Ideal scenario = Patient + Family MemberMember

Screen ward again tomorrow

Screening AlgorithmScreening Algorithm

Enter this respondent on the Screening & Enrollment Log

Training Module 2 Training Module 2 CompleteComplete