好色先生

好色先生

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Abstract Details

Documentation of Code Status in Hospitalized Patients: A Pilot Quality Improvement Project
Practice, Policy, and Ethics
P4 - Poster Session 4 (5:30 PM-6:30 PM)
4-071
This project seeks to improve resident documentation of a pre-existing code status in patients admitted to the stroke service at an academic medical center. We also aim to improve resident comfort with end of life discussions, including comfort with making recommendations regarding care near the end of life.
Recording the presence of a pre-existing code status is a common task assigned to residents. Eliciting this information is important for patients who suffer serious neurologic illness. Failing to perform code status reconciliation (CSR) early in the patient’s hospitalization can lead to inappropriate medical treatment. 
We implemented a reminder in our electronic medical record system (EMR) at 24 hours after admission if no code status was documented in the chart for patients admitted to the stroke service at a comprehensive stroke center. We retrospectively reviewed documentation prior to and after implementation. Using survey monkey we elicited residents’ perception of our intervention. 
EMR for 110 patients was reviewed and no significant increase in documentation was found after implementation of the reminder (16.6% vs 18.5%). 76.9% of the residents found the reminder helpful.  Only 38.46% felt that it led them to have increased code status discussions.  53.85% of the neurology residents did not have any formal training regarding code status discussions prior to beginning residency.  53.85% of the residents desired more training in end of life discussion and 30.77% were not sure and only 15.38% of the residents were comfortable with the training. 
An automated reminder to review code status did not lead to improvement in documentation. Our survey indicated that our residents felt unprepared to discuss code status and prognosis. We plan to develop a lecture series that teaches key components of serious illness communication. We will re-evaluate improvement in discussion and documentation following this intervention. 
Authors/Disclosures
Parneet K. Grewal, MD
PRESENTER 		The institution of Dr. Grewal has received research support from Bristol Myer Squibb Foundation. The institution of Dr. Grewal has received research support from IPSEN Global.
Swati Pradeep, MD (UT Health Science Center) Dr. Pradeep has nothing to disclose.
Benjamin T. Barnes, MD (Augusta University) Dr. Barnes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ArgenX. Dr. Barnes has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen.
Jessica D. Lee, MD, FAAN (University of Kentucky) Dr. Lee has received personal compensation for serving as an employee of 好色先生. The institution of Dr. Lee has received research support from Janssen.
Jessica McFarlin, MD (University of Kentucky) Dr. McFarlin has received personal compensation in the range of $500-$4,999 for serving as a Volunteer Faculty with Vital Talk.