Refining an Advance Care Planning Group Visit intervention a novel intervention to engage older adults in advance care planning

项目摘要 这是Hillary Lum，MD，PhD为Paul B的首次提交。Beeson新兴领导者职业生涯 老龄化发展奖（K76）。Lum博士致力于成为先进护理计划（ACP）的领导者 研究，政策倡议和医疗保健系统的变化，以改善老年人的护理。她是内科医生 医学部老年医学科和姑息医学科医生， 科罗拉多大学医学院。Lum博士的研究重点是完善预先护理计划 小组访问（ACP-GV）干预，以使老年人参与ACP。这份四年培训计划 通过以下方式加速Lum博士作为以患者为导向的研究人员和老龄化领导者的职业发展： 培训：1）高级定性分析; 2）实施科学; 3）老年人的实用临床试验 成年人了她将通过与她的指导团队，高级 课程，指导研究和综合领导力的发展，无论是机构和作为一个健康和 老龄政策研究员。林博士的导师团队和机构资源是特殊的。作为林博士的 主要导师，Cari Levy，医学博士，博士是一位全国公认的研究人员和老年姑息治疗的领导者 并将监督林博士的研究、职业生涯和领导力发展。Lum博士由Jean共同指导 Kutner，医学博士，MSPH，姑息治疗研究的技术领导者和专家，包括老年人的临床试验 成年人了在国家姑息治疗研究中心和科罗拉多健康基金会的资助下， 博士Lum证明，一种新的ACP-GV干预原型增加了ACP讨论， 初级保健中老年人的记录。为了进行真实世界的临床试验， 实施这一干预，下一步的研究步骤是标准化的干预，为一般人群 并通过优先考虑患者、临床医生、工作人员和健康部门的意见，使干预措施适应临床环境 系统领导者。因此，研究目标是：1）开发和完善ACP-GV干预措施， 标准化的基本干预组成部分，以适应整个诊所设置，并优先考虑 ACP结局对主要初级保健利益相关者很重要，2）进行一项试点随机对照试验， 检验改良ACP-GV干预的可行性、可接受性和初步疗效。高潮 这个职业发展奖将确保林博士获得先进的研究技能和知识 对老年人进行ACP-GV干预的全面有效性实施试验， 以结果为中心。此外，她将被专门定位为承担扩大和有影响力的 发挥国家领导作用，领导政策举措，改善非加太国家，对地方、区域和国家产生影响， 改善医疗保健系统提供与患者目标一致的护理。

Project Summary This is an initial submission by Hillary Lum, MD, PhD for the Paul B. Beeson Emerging Leaders Career Development Award in Aging (K76). Dr. Lum is committed to being a leader in advance care planning (ACP) research, policy initiatives, and healthcare system change to improve care for older adults. She is an internist, geriatrician, and palliative medicine physician in the Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine. Dr. Lum's research focuses on refining an Advance Care Planning Group Visit (ACP-GV) intervention to engage older adults in ACP. This proposed 4-year training plan accelerates Dr. Lum's career development as a patient-oriented researcher and leader in aging through training in: 1) advanced qualitative analysis; 2) implementation science; and 3) pragmatic clinical trials in older adults. She will acquire these skills through intensive interactions with her mentoring team, advanced coursework, guided research, and integrated leadership development, both institutionally and as a Health and Aging Policy Fellow. Dr. Lum's mentorship team and institutional resources are exceptional. As Dr. Lum's primary mentor, Cari Levy, MD, PhD is a nationally recognized researcher and leader in geriatric palliative care and will supervise Dr. Lum's research, career, and leadership development. Dr. Lum is co-mentored by Jean Kutner, MD, MSPH, a skilled leader and expert in palliative care research, including clinical trials in older adults. With funding from the National Palliative Care Research Center and The Colorado Health Foundation, Dr. Lum demonstrated that a novel ACP-GV intervention prototype increased ACP discussions and documentation among older adults in primary care. In order to conduct a real-world clinical trial and ultimately implement this intervention, the next research steps are to standardize the intervention for a general population and adapt the intervention to clinical settings by prioritizing input from patients, clinicians, staff, and health system leaders. Thus, the study objectives are to: 1) develop and refine the ACP-GV intervention to be standardized to the essential intervention components, to be adaptable across clinic settings, and to prioritize ACP outcomes important to key primary care stakeholders, and 2) conduct a pilot randomized controlled trial to test the feasibility, acceptability, and preliminary efficacy of the refined ACP-GV intervention. The culmination of this career development award will assure that Dr. Lum gains the advanced research skills and knowledge to conduct a full-scale effectiveness-implementation trial of an ACP-GV intervention for older adults on patient- centered outcomes. Additionally, she will be specifically positioned to assume expanded and influential national leadership roles to lead policy initiatives to improve ACP with local, regional, and national impact and improve healthcare system delivery of care that is aligned with patient goals.