SHM Converge Scientific Abstract ePoster Gallery-MANDATORY SURPRISE QUESTION: IS IT USEFUL? an NYULH SYSTEM-WIDE REVIEW OF THE IMPACT OF THE MSQ RESPONSE

MANDATORY SURPRISE QUESTION: IS IT USEFUL?

an NYULH SYSTEM-WIDE REVIEW OF THE IMPACT OF THE MSQ RESPONSE
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This study evaluated whether the Mandatory Surprise Question (MSQ) asked at hospital admission—“Would you be surprised if this patient died within the next 6 months?”—is associated with advance care planning (ACP) activity during hospitalization. Using a retrospective, propensity score-matched cohort design, the authors reviewed 5 years of admissions to the Hospital Medicine service across three NYULH sites. The study included patients who either died in the hospital or were discharged to hospice. After matching, 9,136 encounters were analyzed. Key findings: - Patients whose admission MSQ response was “No” had 44% higher odds of having ACP documentation or a palliative care consultation compared with those whose response was “Yes” (p < 0.001). - ACP documentation or palliative care consultation also occurred earlier for patients with a “No” response, by about 2.7 days on average (p < 0.001). The authors conclude that a “No” response to the MSQ is associated with both greater use and earlier timing of ACP-related activities. However, because prior research has shown variability in provider accuracy when answering the MSQ, the study suggests that health systems should support clinicians with tools that help identify patients at higher risk of mortality early in admission. This could improve timely ACP, palliative care, geriatrics consultation, and possibly hospice referral.

Asset Subtitle

Ankita Agarwal

Meta Tag

Author List Ankita Agarwal, Benjamin Verplanke, Heather Menzer, Jesse Rafel, Kolby Johnson, Lauren Messing

Category Research

Concept Mandatory Surprise Question

Concept Advance care planning

Concept Mortality Risk

Concept Hospitalized Patient

Concept Retrospective Cohort Study

Distinguished Non-Finalist

Presenter Organization NYU Langone

Presenting Author Ankita Agarwal

Track Quality Improvement

Keywords

Mandatory Surprise Question

advance care planning

palliative care consultation

hospital admission

mortality risk

retrospective cohort study

propensity score matching

hospice referral

hospital medicine

early intervention

Mandatory Surprise Question

Advance care planning

Mortality Risk

Hospitalized Patient

Retrospective Cohort Study