(P215) IMPROVING FAMILY ENGAGEMENT IN ACUTE CARDIOVASCULAR CARE (THE NGAGE TRIAL)

Background: Engaging families in care is recognized as an increasingly important and key aspect of healthcare delivery. Our multidisciplinary team designed the NGAGE tool to empower family members to identify their desired areas of involvement in care and communicate them to the healthcare team. The primary objective of this study was to evaluate the feasibility of the NGAGE tool and intervention. The secondary objective was to evaluate the impact of the NGAGE tool on family outcomes.

METHODS AND RESULTS: We conducted a single-center pilot feasibility randomized controlled trial in the acute cardiac unit of a tertiary care academic hospital. Family members were randomized in a 1:1 manner to the intervention or usual care. The study population included family members (age ≥ 18 years) of patients who were admitted to the cardiovascular unit for an expected stay of more than 48 hours and could communicate in English or French. A family member was considered anyone with a biological, emotional, or legal relationship with the patient whom the patient wanted to be involved in their care. Participants in the intervention group had access to the NGAGE tool, which allowed them to request engagement activities. Engagement activities included communication, information, education, decision-making, and direct care. Participants indicated which care areas they wanted to participate in or increase their participation. This request was then transmitted to the treating healthcare team. At enrolment, participant demographics, family activation, and current family engagement scores were collected. Following hospital discharge, mental health, care satisfaction, and family engagement scores were collected.
There were 87 participants (47 intervention, 40 control) in the analysis. One-quarter of family members approached agreed to participate in the study. Mean recruitment was 10 participants/month. Among the participants assigned to the intervention group, two-thirds (66%) used the NGAGE tool (mean tool use=1.5±0.9 uses; range 1-5 uses; Figure). Nearly all engagement requests (44/45; 98%) were completed. 60 participants (69%) completed follow-up. There were no differences in family activation or engagement at baseline, nor differences in mental health scores, satisfaction, or engagement at follow-up (P>0.05).

Conclusion: The data supports the feasibility of the NGAGE tool and intervention. The results will inform the design of a multi-center effectiveness trial of the NGAGE tool.