Quality Improvement Project: Assessing the Use of Advanced Care Planning Documentation for Patients at High Risk of 30-day Mortality on Hospital Medicine Services
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Advance Care Planning
- Sponsor
- Duke University
- Enrollment
- 743
- Locations
- 1
- Primary Endpoint
- Proportion of patients who have advanced care planning notes completed during the admission
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
Hospitalized patients and their families are often unprepared regarding end-of-life care. Even patients with high risk of mortality within the index admission or 30 days after admission often do not have clearly defined goals of care. This lack of clarity can create difficult scenarios for patients, their families, and care providers. Lack of communication and documentation of these goals can lead to unnecessary tests, procedures, and readmissions. By creating advanced care planning education for the hospital medicine department, a standardized note template, and EMR utilization for storage and reference of patient's goals of care documentation we aim to facilitate the conveyance of patient's wishes/preferences across different care providers and across separate encounters within the healthcare system. For this study, we will use a pre-post study design to evaluate the implementation of this quality improvement intervention.
Investigators
Eligibility Criteria
Inclusion Criteria
- •All patients admitted to the inpatient medicine service with high risk of mortality.
Exclusion Criteria
- •Involuntary commitment during the index admission
Outcomes
Primary Outcomes
Proportion of patients who have advanced care planning notes completed during the admission
Time Frame: Hospital admission, up to 7 days
As measured by medical record review (Post-implementation)
Secondary Outcomes
- Proportion of patient who have documentation utilizing the electronic health record dotphrase note template(Hospital admission, up to 7 days)
- Proportion of patients who receive palliative care consults(Hospital admission, up to 7 days)
- Proportion of patients who are billed for advanced care planning(Hospital admission, up to 7 days)
- Proportion of patients who are discharged to hospice(Hospital discharge, up to 7 days)
- Proportion of patients who have an appointment to the palliative care clinic(Up to 1 month)