SHM Converge Scientific Abstract ePoster Gallery-Impact of Advance Care Planning Conversations on Clinical Outcomes in High Risk Hospitalized Patients

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This retrospective study examined whether inpatient advance care planning (ACP) conversations were associated with outcomes in high-risk hospitalized patients from January 2021 to March 2024. High-risk patients were defined as those in the top 25th percentile for predicted 12-month mortality and with at least a 20% predicted 30-day readmission risk.<br /><br />Patients were divided into two groups: those with a documented ACP conversation in a standardized EHR template during hospitalization, and those without such documentation. The main outcome was 30-day readmission; secondary outcomes included 30-day ICU readmission, in-hospital mortality, and discharge disposition. Outcomes were compared using univariate analysis and logistic regression.<br /><br />The findings suggested that patients in the ACP group had a higher adjusted odds of 30-day readmission, about 2.1 times greater than those without documented ACP. ACP patients also had longer hospital lengths of stay. For discharge disposition, there was a trend toward more hospice discharges and fewer skilled nursing facility discharges among ACP patients. The study did not indicate a clear beneficial effect of inpatient ACP conversations on short-term readmission outcomes in this high-risk population.<br /><br />Overall, the results highlight the complexity of caring for very ill hospitalized patients and suggest that ACP documentation may reflect greater illness severity or care complexity rather than improved short-term clinical outcomes. The authors conclude that more research is needed to better understand the role and impact of inpatient ACP conversations on patient outcomes.

Asset Subtitle

Samantha Wang

Meta Tag

Author List Brian Schenone, Briththa Seevaratnam, Eileen F. Kiamanesh, Lisa Shieh, Megha Tandel, Samantha Wang, Winifred Teuteberg, Yingjie Weng

Category Research

Concept Advance care planning

Concept 30-Day Readmission

Concept American College of Physicians

Concept High-Risk Hospitalized Patient

Concept Retrospective Cohort Study

Distinguished Non-Finalist

Presenter Organization Stanford University

Presenting Author Samantha Wang

Track Communication

Keywords

advance care planning

inpatient hospitalization

high-risk patients

30-day readmission

ICU readmission

in-hospital mortality

discharge disposition

electronic health record

retrospective study

logistic regression

Advance care planning

30-Day Readmission

American College of Physicians

High-Risk Hospitalized Patient

Retrospective Cohort Study