The PACT Conversation Trigger Tool: Assessing Reliability, Acceptability and Validity (QI706)

1.Describe a novel approach to screening patients for unmet advance care planning needs.2.Describe the reliability, acceptability and validity of the PACT Trigger Tool. Many patients who would benefit from Advance Care Planning (ACP) do not have discussions with providers. One barrier is the lack of a standardized method to identify these patients. As part of a larger initiative whose aim was to increase ACP conversations, the Preference-Aligned Communication and Treatment (PACT) Trigger Tool was developed to help inpatient clinicians of any discipline identify patients with ACP needs based on serious illness, care dependency and functional decline. This study evaluated the reliability, acceptability and validity of the tool. To assess inter-rater reliability, 100 patients were double-scored across participating hospitals. For acceptability, nurses (N=185) completed a 10-item survey using a Likert scale. Validity was measured using retrospective chart reviews (N=135). The PACT Trigger Tool demonstrated moderate to high reliability. A factor analysis of the acceptability survey showed that nurses found the tool useful (M=4.07, SD=0.73) and easy to complete (M=4.24, SD=0.67). Nurses who had been trained to use the tool found it easier to complete (F(1, 183)=12.69, p