SHM Converge Scientific Abstract ePoster Gallery-Identifying Hospitalized Patients Who May Benefit From Serious Illness Conversations

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This poster examines whether hospitalized patients who may benefit from a Serious Illness Conversation (SIC) can be identified using Epic’s Readmission Risk Score (RRS) combined with clinicians’ judgments based on the “surprise question.”<br /><br />The study reviewed adult admissions to a general medicine service at Brigham and Women’s Hospital from January 2019 to October 2021. Patients had an RRS of at least 28%. Three clinicians independently reviewed charts to determine whether they would be surprised if the patient died within 12 months, whether the patient could meaningfully participate in an SIC, and, if not, why not. Each chart was reviewed by two clinicians, with disagreements resolved by consensus.<br /><br />The results showed that clinicians would not be surprised if 77% of these patients died within the next year. Most of these patients were also thought to be able to meaningfully take part in a serious illness conversation. When patients could not participate, encephalopathy and dementia were the most common reasons.<br /><br />The authors conclude that RRS, when paired with clinician judgment, may be a practical though imperfect tool for identifying hospitalized patients who could benefit from SICs. The study suggests that this approach could help improve the timing of important goals-of-care conversations during hospitalization.

Asset Subtitle

Myrna K. Serna

Meta Tag

Author List Anuj K. Dalal, Cathy Yoon, Hanna B. Vollbrecht, Jeffrey L. Schnipper, Joshua Lakin, Julie Fiskio, Katrina Grace G. Sadang, Myrna K. Serna

Category Research

Concept Readmission Risk Score

Concept Serious Illness Conversation

Concept Clinician Judgment

Concept Mandatory Surprise Question

Concept Encephalopathy

Distinguished Non-Finalist

Presenter Organization University of Texas Medical Branch

Presenting Author Myrna K. Serna

Track Geriatrics

Keywords

Serious Illness Conversation

SIC

Readmission Risk Score

RRS

hospitalized patients

surprise question

goals of care

general medicine

clinician judgment

Brigham and Women’s Hospital

Readmission Risk Score

Serious Illness Conversation

Clinician Judgment

Mandatory Surprise Question

Encephalopathy