Table 4

Independent outcome variables 

VariableCodingSource
Implementation periodWeeks from time 0.Programme manager
Implementation quality
 ParticipationProportion of providers who complete all assigned training and workshopsLearning management system and programme manager
 FidelityProportion of sessions at each site that adhered to the course content and teaching methods.Programme manager
Healthcare system/ED-level variables
 Health systemReferred to in Table 3.Programme manager
 ED1–35.Programme manager
 ED volume30 000–49 999 visits, 50 000–69 999 visits, 70 000–89 999 visits and >90 000 visits.Programme manager
 OwnershipNon-profit, government and for profit.Programme manager
 Emergency medicine residency training siteYes/noProgramme manager
 Free-standing EDYes/no.Programme manager
 Dedicated ED social worker/care managerYes/no.Programme manager
 US regionNortheast, Midwest, Southeast, Southwest and West.Programme manager
 Metropolitan status+Yes/no.Programme manager
 Outpatient palliative careYes/no.Programme manager
 EHREpic, Cerner and Pysis/Pulsecheck.Programme manager
 Trauma centreYes/no.Programme manager
Provider variables
 Provider age*Average years (physicians and nurses).Provider survey
 Provider gender*% Female (physicians and nurses).Provider survey
 Provider race/ethnicity*% White (physicians and nurses).Provider survey
 Provider years in practice*Average years (physicians and nurses).Provider survey
  Emergency provider advanced certification in hospice and palliative medicine*Yes/no (physician and nurse).Provider survey
Patient variables
 AgeYears.Master beneficiary summary file and base segment
 GenderFemale, male and other.Master beneficiary summary file and base segment
 Race/ethnicityAsian, black, Hispanic, white, North American Native, unknown and other.Master beneficiary summary file and base segment
 Gagne Index41 Count of conditions.Inpatient and outpatient research identifiable files
  • *Physician and nurse provider variables will be considered separately; +population estimates by Metropolitan Statistical Area  (MSA) are based on estimates of the civilian non-institutionalised population of the US as of 1 July 2013, from the 2013 National Health Interview Survey, National Center for Health Statistics, compiled according to the 2013 Office of Management and Budget definitions of core-based statistical areas. See http://www.census.gov/population/metro/ for more about metropolitan statistical area definitions.

  • ED, emergency department; EHR, electronic health record; ELNEC, End-of-Life Nursing Education Consortium; EPEC-EM, Education in Palliative and End-of-Life Care for Emergency Medicine.