What is a pragmatic research trial?
It is designed with input from health systems. The trial creates evidence to improve care in real-world settings like community clinics, hospitals, and health systems.

Background
Adults can understand and share their values, goals, and needs about future medical care through advanced care planning (ACP). One of the goals of a pragmatic research trial ‘SHARING Choices’ was to encourage discussions about ACP with older adults and their families.

Co-creation
SHARING Choices teamed up with two large health systems to evaluate its effectiveness in real-world settings. The project involved a lot of collaboration with stakeholders. Champions, patients, and ACP facilitators were significant collaborators for the project's success. We created archetypes at the midway point of the study to understand the needs across the three roles and team dynamics. The archetypes also showed the range of strengths, weaknesses, and connections that impacted the activities of the trial within complex healthcare environments.

Output (Design Prototypes)

• 6 archetypes for Champions

• 5 archetypes for ACP Facilitators

• 6 archetypes for Patients

Utility
The team expects the archetypes to be most useful for hiring, training, and supervising staff in future implementation in other health systems. Recent literature suggests that the process of designing archetypes can make medical care teams more compassionate and helps to stimulate engagement with patients.

Collaborator
Johns Hopkins Bloomberg School of Public Health
Implementation Science, Advanced Care Planning,
2020, Baltimore, USA