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Increasing Serious Illness Conversations in Patients at High Risk of One-Year Mortality Using Improvement Science: A Quality Improvement Study.
Healthcare (Basel)
January 2025
Department of Medicine, Division of Geriatrics and Palliative Medicine, Glennan Center for Geriatrics and Gerontology, Eastern Virginia Medical School at Old Dominion University, Norfolk, VA 23508, USA.
Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores.
View Article and Find Full Text PDFAddressing Inadequate Documentation of Unilateral Do-Not-Resuscitate Orders.
JAMA
January 2025
Department of Pulmonary and Critical Care, University of Chicago, Chicago, Illinois.
Improving Advanced Care Planning Discussions at an Internal Medicine Clinic.
Cureus
December 2024
Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
Objective: The project aimed to standardize advanced care planning (ACP) at an internal medicine clinic by initiating physician-patient communication regarding the patient's knowledge, understanding, and openness to pursuing advanced medical directives.
Methods: Data collection was conducted from February 1 to April 1, 2024, with the study concluding on April 24, 2024. ACP was facilitated through an initial standardized six-question pre-intervention survey in both English and Spanish.
The Patient Perspective on Discussion of Perioperative Code Status: A Blind Spot in Efforts to Promote Goal-Concordant Surgical Care.
J Palliat Med
January 2025
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Despite long-standing recognition that providers should discuss DNR (do-not-resuscitate) orders prior to surgery, there is evidence that perioperative code status discussions are frequently of limited quality. Limited attention has been paid to patient perspectives. Determine the scope of literature on management of perioperative DNR orders from the patient perspective.
View Article and Find Full Text PDFConsideration of advance directives by emergency physicians in patients with cardiac arrest: a clinical vignettes-based qualitative study.
Int J Emerg Med
November 2024
Department of Emergency Medicine and Critical Care, CHU Besançon, Besançon, F-25000 , France.
Background: Emergency medical services (EMS) must incorporate the patient's physiologic state and end-of-life wishes when determining whether to initiate and/or continue cardiopulmonary resuscitation (CPR). This study aims to describe and analyze the use of advance directives (ADs) in CPR by emergency physicians (EPs).
Methods: A qualitative approach using semi-directed interviews was conducted.
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