Concordance of Advance Care Plans With Inpatient Directives in the Electronic Medical Record for Older Patients Admitted From the Emergency Department

Corita R. Grudzen, Philip Buonocore, Jonathan Steinberg, Joanna M. Ortiz, Lynne D. Richardson, Rebecca A. Aslakson, Katherine Ast, Ronit Elk, Kimberly K. Garner, Robert Gramling, Corita Grudzen, Arif H. Kamal, Sangeeta Lamba, Thomas W. LeBlanc, Ramona L. Rhodes, Eric Roeland, Dena Schulman-Green, Kathleen T. Unroe, and the AAHPM Research Committee Writing Group, AAHPM Research Committee Writing Group

Research output: Contribution to journalArticle

Abstract

Context Measuring What Matters identified quality indicators to examine the percentage of patients with documentation of a surrogate decision maker and preferences for life-sustaining treatments. Objectives To determine the rate of advance care planning in older adults presenting to the emergency department (ED) and translation into medical directives in the electronic medical record (EMR). Methods A convenience sample of adults 65 years or older was recruited from a large urban ED beginning in January 2012. We administered a baseline interview and survey in English or Spanish, including questions about whether patients had a documented health care proxy or living will. For patients admitted to the hospital who had a health care proxy or living will, chart abstraction was performed to determine whether their advance care preferences were documented in the EMR. Results From February 2012 to May 2013, 53.8% (367 of 682) of older adults who completed the survey in the ED reported having a health care proxy, and 40.2% (274 of 682) had a living will. Of those admitted to the hospital, only 4% (4 of 94) of patients who said they had a living will had medical directives documented in the EMR. Similarly, only 4% (5 of 115) of patients who had a health care proxy had the person's name or contact information documented in their medical record. Conclusion About half of the patients 65 years or older arriving in the ED have done significant advance care planning, but most plans are not recorded in the EMR.

Original languageEnglish (US)
Pages (from-to)647-651
Number of pages5
JournalJournal of Pain and Symptom Management
Volume51
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Fingerprint

Electronic Health Records
Living Wills
Hospital Emergency Service
Inpatients
Proxy
Advance Care Planning
Delivery of Health Care
Documentation
Names
Medical Records
Interviews

Keywords

  • advance care planning
  • emergency medicine
  • Quality improvement

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Grudzen, C. R., Buonocore, P., Steinberg, J., Ortiz, J. M., Richardson, L. D., Aslakson, R. A., ... AAHPM Research Committee Writing Group (2016). Concordance of Advance Care Plans With Inpatient Directives in the Electronic Medical Record for Older Patients Admitted From the Emergency Department. Journal of Pain and Symptom Management, 51(4), 647-651. https://doi.org/10.1016/j.jpainsymman.2015.12.318

Concordance of Advance Care Plans With Inpatient Directives in the Electronic Medical Record for Older Patients Admitted From the Emergency Department. / Grudzen, Corita R.; Buonocore, Philip; Steinberg, Jonathan; Ortiz, Joanna M.; Richardson, Lynne D.; Aslakson, Rebecca A.; Ast, Katherine; Elk, Ronit; Garner, Kimberly K.; Gramling, Robert; Grudzen, Corita; Kamal, Arif H.; Lamba, Sangeeta; LeBlanc, Thomas W.; Rhodes, Ramona L.; Roeland, Eric; Schulman-Green, Dena; Unroe, Kathleen T.; and the AAHPM Research Committee Writing Group; AAHPM Research Committee Writing Group.

In: Journal of Pain and Symptom Management, Vol. 51, No. 4, 01.04.2016, p. 647-651.

Research output: Contribution to journalArticle

Grudzen, CR, Buonocore, P, Steinberg, J, Ortiz, JM, Richardson, LD, Aslakson, RA, Ast, K, Elk, R, Garner, KK, Gramling, R, Grudzen, C, Kamal, AH, Lamba, S, LeBlanc, TW, Rhodes, RL, Roeland, E, Schulman-Green, D, Unroe, KT, and the AAHPM Research Committee Writing Group & AAHPM Research Committee Writing Group 2016, 'Concordance of Advance Care Plans With Inpatient Directives in the Electronic Medical Record for Older Patients Admitted From the Emergency Department', Journal of Pain and Symptom Management, vol. 51, no. 4, pp. 647-651. https://doi.org/10.1016/j.jpainsymman.2015.12.318
Grudzen, Corita R. ; Buonocore, Philip ; Steinberg, Jonathan ; Ortiz, Joanna M. ; Richardson, Lynne D. ; Aslakson, Rebecca A. ; Ast, Katherine ; Elk, Ronit ; Garner, Kimberly K. ; Gramling, Robert ; Grudzen, Corita ; Kamal, Arif H. ; Lamba, Sangeeta ; LeBlanc, Thomas W. ; Rhodes, Ramona L. ; Roeland, Eric ; Schulman-Green, Dena ; Unroe, Kathleen T. ; and the AAHPM Research Committee Writing Group ; AAHPM Research Committee Writing Group. / Concordance of Advance Care Plans With Inpatient Directives in the Electronic Medical Record for Older Patients Admitted From the Emergency Department. In: Journal of Pain and Symptom Management. 2016 ; Vol. 51, No. 4. pp. 647-651.
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AU - Gramling, Robert

AU - Grudzen, Corita

AU - Kamal, Arif H.

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