Supporting Transitions and Empowering Preferences (STEP) for long-term care residents making hospital transfer decisions
A Pre-Post Trial Evaluating the Supporting Transitions and Empowering Preferences (STEP) Decision Support Intervention for Long-Term Care Residents Facing Hospital Transfer Decisions During Acute Health Crises
This project tests whether the STEP toolkit helps long-term care residents, their substitute decision-makers, and nurses make clearer hospital transfer decisions by reducing decisional conflict and improving nurse confidence.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 200 (estimated) |
| Ages | 55 Years and up |
| Sex | All |
| Sponsor | Bruyère Health Research Institute. Academic / other |
| Locations | 2 sites (Ottawa, Ontario and 1 other locations) |
| Trial ID | NCT07153341 on ClinicalTrials.gov |
What this trial studies
The trial introduces the STEP decision-support toolkit into two Ottawa long-term care homes and implements it at admission, during care conferences, and during acute events. Residents—or their substitute decision-makers—and nursing staff will use STEP-guided conversations while trained nurses support the discussions. Participants complete brief surveys measuring decisional conflict for residents and care partners and self-efficacy for nurses, with data collected before and after implementation. Researchers will compare pre- and post-implementation measures at the two sites to determine whether STEP improves shared decision-making around hospital transfers.
Who should consider this trial
Good fit: Ideal candidates are long-term care residents aged 55 or older (or their substitute decision-makers) and nurses or allied staff at Perley Health or Bruyère Health Saint‑Louis who can communicate in English or French and participate in STEP-guided discussions.
Not a fit: People who are not at the two participating LTC homes, who cannot communicate in English or French, or whose clinical situation requires immediate emergency transfer where a decision aid cannot influence timing may not benefit.
Why it matters
Potential benefit: If successful, STEP could reduce uncertainty and stress for residents and care partners, increase nurses' confidence, and lead to more resident-centered transfer choices and fewer unnecessary hospital admissions.
How similar studies have performed: Other decision-support tools and structured communication interventions in long-term care have shown promise in reducing decisional conflict and avoidable transfers, but STEP is a locally co-designed toolkit that still requires testing in this implementation.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria Residents-care partner dyads: * Must be residents of either Perley Health or Bruyère Health Saint-Louis LTC home. * Residents must be 55 years of age or older. * Must be able to communicate in French or English. Both members of the dyad will be included where applicable. For dyads in which residents do not have the capacity to participate, inclusion will occur through the involvement of their substitute decision-maker (e.g., power of attorney for personal care). LTC staff: * Must be a nurse, nurse practitioner, social service worker or physician actively involved in care planning, annual conferences, or managing acute health events at Perley Health or Bruyère Health. * Must have been employed at the LTC home for at least 6 months to ensure familiarity with the care environment and residents. * Must play a role in facilitating discussions, providing clinical input (where applicable), or guiding decision-making processes related to hospital transitions or acute care management. * Must be able to communicate in French or English.
Where this trial is running
Ottawa, Ontario and 1 other locations
- Bruyère Health Saint-Louis Long-Term Care — Ottawa, Ontario, Canada (Recruiting)
- Perley Health — Ottawa, Ontario, Canada (Recruiting)
Study contacts
- Study coordinator: Daniel Kobewka, MD
- Email: DKobewka@toh.ca
- Phone: 613-798-5555
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.