A practical EHR-based intervention had a modest effect in a randomized trial.
Goals-of-care discussions for hospitalized patients with serious illnesses reduce intensity of care and promote patient-centered outcomes near the end of life. However, time and resource limitations have affected the success of prior interventions that aimed to promote these discussions.
In this randomized study of 2500 hospitalized older patients (age, ≥80; or ≥55 with ≥1 chronic condition such as dementia, poor-prognosis cancer, or chronic cardiovascular, lung, liver, or kidney disease), researchers assessed effects of an intervention to prompt goals-of-care discussions. For each patient, members of the primary hospital team received a 1-page, electronic health record (EHR)-generated guide via email that included current code status, prior…
Reviewing Author
DisclosuresConsultant/Advisory BoardNEJM Healer Advisory Group; Aquifer Clinical Excellence; NBME Clinical Reasoning
Grant/Research SupportSouthern Group on Educational Affairs (SGEA)
Editorial BoardsDiagnosis
Leadership Positions in Professional SocietiesUndergraduate Medical Education (UME) Section Chair, Southern Group on Educational Affairs (SGEA); Chair of Early Career Physicians, American College of Physicians (ACP), Virginia Chapter
DisclosuresConsultant/Advisory BoardNEJM Healer Advisory Group; Aquifer Clinical Excellence; NBME Clinical Reasoning
Grant/Research SupportSouthern Group on Educational Affairs (SGEA)
Editorial BoardsDiagnosis
Leadership Positions in Professional SocietiesUndergraduate Medical Education (UME) Section Chair, Southern Group on Educational Affairs (SGEA); Chair of Early Career Physicians, American College of Physicians (ACP), Virginia Chapter