SHM Converge Scientific Abstract ePoster Gallery-Who Gets (And Who Should Get) a Serious Illness Conversation in the Hospital? An Analysis of Electronic Health Record Factors

Who Gets (And Who Should Get) a Serious Illness Conversation in the Hospital? An Analysis of Electronic Health Record Factors

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This study examined whether Epic’s Readmission Risk Score, available on hospital admission, could help identify patients who may benefit from a Serious Illness Conversation (SIC). Researchers analyzed 6,853 general medicine inpatient encounters from October 2018 to August 2019 at Brigham and Women’s Faulkner Hospital.<br /><br />Two main questions were studied: whether Readmission Risk predicts 6-month mortality, and whether it is associated with documented SICs during admission. For mortality prediction, the score showed adequate discrimination, with an AUC of 0.71, meaning it had moderate ability to distinguish patients who died within six months from those who did not. For SICs, only 59 encounters (0.9%) had a documented SIC. In a matched case-control analysis, higher Readmission Risk was significantly associated with SIC documentation: for every 10-point increase in Readmission Risk, the odds of having an SIC increased by 42% (OR 1.42, 95% CI 1.24–1.63, P=0.01). Other factors such as age, race, ethnicity, language, and insurance were not significant predictors in the model.<br /><br />The study concludes that Readmission Risk on admission may be a practical tool for early, systematic identification of hospitalized patients who are at higher risk of death and may benefit from a Serious Illness Conversation.

Asset Subtitle

Myrna K. Serna

Meta Tag

Author List Anuj K. Dalal, Cathy Yoon, Jeffrey L. Schnipper, Julie Fiskio, Myrna K. Serna, Savanna Plombon

Category Research

Concept Readmission Risk Score

Concept Serious Illness Conversation

Concept Six-Month Mortality

Distinguished Non-Finalist

Presenter Organization Brigham and Women's Hospital

Presenting Author Myrna K. Serna

Track Geriatrics

Keywords

Epic Readmission Risk Score

Serious Illness Conversation

hospital admission

6-month mortality

general medicine inpatients

risk prediction

AUC 0.71

documented SIC

matched case-control

Brigham and Women’s Faulkner Hospital

Readmission Risk Score

Serious Illness Conversation

Six-Month Mortality