Quality Improvement Project for Advance Care Planning Tool in Hospital Medicine

Completed

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.

Recruitment & Eligibility

Inclusion Criteria

All patients admitted to the inpatient medicine service with high risk of mortality.

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
High risk of mortality	Advance Care Planning Discussion	Adult patients admitted to the hospital medicine service with a high risk of mortality

Primary Outcome Measures

Name	Time	Method
Proportion of patients who have advanced care planning notes completed during the admission	Hospital admission, up to 7 days	As measured by medical record review (Post-implementation)

Secondary Outcome Measures

Name	Time	Method
Proportion of patient who have documentation utilizing the electronic health record dotphrase note template	Hospital admission, up to 7 days	As measured by medical record review (Post-implementation)
Proportion of patients who are billed for advanced care planning	Hospital admission, up to 7 days	As measured by medical record review (Post-implementation)
Proportion of patients who receive palliative care consults	Hospital admission, up to 7 days	As measured by medical record review (Post-implementation)
Proportion of patients who are discharged to hospice	Hospital discharge, up to 7 days	As measured by medical record review (Post-implementation)
Proportion of patients who have an appointment to the palliative care clinic	Up to 1 month	As measured by medical record review (Post-implementation)

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