Code Status Discussions With Medical In-patients
Conditions
Keywords
Code status, CPR, EMR, Death language
Brief summary
In order to systematically improve code status communication and documentation while clarifying how providers understand code status decisions, we propose the Choice of Diction's Effect Electronic Measures of Resuscitation Study Inpatient (CODE-EMRS.I) with 3 aims: Aim 1 - Determine rate of patient utilization of code status invitation (research) via the Portal (Hypothesis 1: Participants with an existing Portal are more likely to participate in research than new signups); Aim 2 - Evaluate different phrasings in code status prompts with and without death language (Hypothesis 2: Participants are more likely to pick no code with death language than without); Aim 3 - Determine how objective data drives physician agreement on code status decision (Hypothesis 3: Physicians are more likely to disagree with full code decisions for poor GO-FAR, but not CCI). Participants will fill out all study questionnaires electronically, but have options within these to ask to speak to a study physician/their own physician for clarification. After completing the surveys, the research associate will deliver the patient's code status decision to the attending of record and ask their views on it. Once a week, participants who have expressed interest in the study (by clicking the "I am interested" button) but have not completed the study will receive a reminder to complete the study as well as an offer to withdraw from the study in that same communication.
Interventions
We will explicitly mention death when letting the participant know about CPR
Sponsors
Study design
Eligibility
Inclusion criteria
* Age \>65, English-fluency in reading and speaking, and the capacity to consent
Exclusion criteria
* Requiring ICU-level care
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Code status decision | At enrollment |
| Physician of record decision for and agreement with code status | Within 24 hours of patient decision |
Countries
United States
Contacts
Assistant Professor of Medicine