التفاصيل البيبلوغرافية
| العنوان: |
Impact of an Electronic Medical Record Alert on Code Status Documentation for Hospitalized Patients With Advanced Cancer. |
| المؤلفون: |
Switzer, Benjamin, Jazieh, Khalid, Bernstein, Eden, Harris, David |
| المصدر: |
JCO Oncology Practice; Mar2020, Vol. 16 Issue 3, pe257-e263, 7p |
| مصطلحات موضوعية: |
CANCER patients, CARDIOPULMONARY resuscitation, DOCUMENTATION, HOSPICE care, HOSPITAL patients, HOSPITAL medical staff, MEDICAL care costs, PATIENT satisfaction, TUMOR classification, ADVANCE directives (Medical care), RETROSPECTIVE studies, ELECTRONIC health records, DESCRIPTIVE statistics, TERTIARY care |
| مصطلحات جغرافية: |
OHIO |
| مستخلص: |
PURPOSE: Cardiopulmonary resuscitation in hospitalized patients with advanced cancer is associated with high rates of morbidity and mortality. Although advance care planning (ACP) in this population improves quality, patient satisfaction, hospice use, rates of harm, and health care costs, ACP documentation rates remain low. We observed changes in ACP documentation by internal medicine residents within a tertiary hospital's inpatient oncology service after a mandatory training module and enterprise-wide modification in electronic health medical records (EHMR). METHODS: For patients admitted to the Cleveland Clinic oncology service, this 16-week retrospective review observed resident code status (CS) documentation through admission notes and direct EHMR orders before and after implementation of an ACP training module and CS best practice alert (BPA). In addition, residents were surveyed on perceived barriers to CS documentation. RESULTS: In 535 unique admissions (244 before BPA, 291 after BPA), residents exhibited a 14.4% increase (from 47.1% to 61.5%) in admission note CS documentation and an 18.2% increase (from 12.7% to 30.9%) in CS orders at time of discharge. The most common self-reported barrier to ACP documentation was forgetting to discuss, with first-, second-, and third-year residents admitting to feeling uncomfortable in orchestrating ACP conversations at rates of 58%, 6%, and 5%, respectively. CONCLUSION: Resident ACP documentation remains suboptimal in the high-risk cohort of hospitalized patients with advanced cancer. However, rates seem to be positively influenced by online modules and EHMR-based interventions. Additional efforts to improve the current practice and culture of ACP remain a crucial aspect in the quality and safety of our approach to patient care. [ABSTRACT FROM AUTHOR] |
|
Copyright of JCO Oncology Practice is the property of American Society of Clinical Oncology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
