Inpatient Hospice Transitions Checklist

Eligibility criteria

Inclusion Criteria:
Clinicians: Physicians, nurse practitioners, physician assistants, nurses, or social workers practicing in acute care; participate in goals-of-care, advance care planning (ACP), hospice, or care transition discussions for hospitalized adults with dementia; and can complete study activities in English; and use the electronic health record for clinical documentation and patience care (EPIC)
Surrogates: Adults aged =18 years identified as the legally authorized representative, healthcare proxy, or next of kin who participate in goals-of-care, ACP, or hospice-related discussions during hospitalization and can complete study communication in English.
PLWD Inclusion Criteria: Adults aged ≥60 years admitted to an acute care inpatient service who lack decisional capacity, have an EHR-documented dementia diagnosis, are identified through the NYU Dementia Epic Registry from the ED-LEAD trial and a "No" response to the Mandatory Surprise Question ("Would you be surprised if this person were to die within the next 6 months?"), and have clinical circumstances prompting goals-of-care or hospice-related discussions.
Exclusion Criteria:
Clinicians: Individuals who do not routinely participate in ACP, hospice, or care transition communication; decline or do not complete required training; or share responsibility for a patient encounter with an enrolled senior clinician.
Surrogates: Not the primary decision-maker for the PLWD and unable to find or contact the LAR for consent

The sponsor's own eligibility wording, lightly reformatted. The study team makes the final eligibility decision — worth discussing with your doctor.

Eligibility criteria as of 2026-10-22