Feasibility of the Comfort Measures Only Time Out (CMOT)
End of Life, Respiratory Failure, Ventilatory Failure
About this trial
This is an interventional supportive care trial for End of Life
Eligibility Criteria
Patient Inclusion Criteria Age ≥ 18 Decision made for withdrawal of mechanical ventilation (WMV) by patient/surrogate and ICU team WMV has not yet occurred Patient Exclusion Criteria • None ICU Clinician Inclusion Criteria: ICU nurse, Physician/Advance Practice Provider, or respiratory therapist Age ≥ 18 Providing direct care to WMV patient for at least 1-hour pre-extubation ICU Clinician Exclusion criteria: • Unable to communicate in English
Sites / Locations
- Beth Israel Deaconess Medical center
Arms of the Study
Arm 1
Experimental
Check-list Arm
This feasibility study will test an ICU team-based time and and check-list intervention, the Comfort Measures Only Time Out (CMOT). The CMOT is designed to improve ICU team communication and better address patient comfort at the end of life. Participants in the CMOT are intensive care unit clinicians who are caring for a patient who is about to undergo palliative withdrawal of mechanical ventilation at the end of life. Feasibility will be assessed by: recruitment rates, protocol adherence, and acceptability to clinicians. Patient level outcomes such as distressful episodes/person-time alive will also be collected as a component of routine care in this exploratory analysis. The maximum time any participant (ICU clinician or patient) will be participating in the study is about four hours.