Background: Advance care planning can be challenging for both patients and providers.  Barriers to understanding patients’ goals of care include patient and provider discomfort with the topic, as well as family and cultural dynamics.  The Stanford Letter Advance Directive (LAD) is a simple tool written at a fifth grade reading level in eight different languages [...]

Background: Advance care planning can be challenging for both patients and providers.  Barriers to understanding patients’ goals of care include patient and provider discomfort with the topic, as well as family and cultural dynamics.  The Stanford Letter Advance Directive (LAD) is a simple tool written at a fifth grade reading level in eight different languages [...]

Background: Code status discussions often link do-not-intubate (DNI) orders with do-not-resuscitate (DNR) orders, although cardiac arrest accounts for less than 2% of endotracheal intubations. DNR orders are more commonly implemented for older patients with more comorbid conditions regardless of the reason for hospitalization, and are associated with withholding treatments outside of the cardiac arrest setting. [...]

Background: Code status discussions often link do-not-intubate (DNI) orders with do-not-resuscitate (DNR) orders, although cardiac arrest accounts for less than 2% of endotracheal intubations. Furthermore, in-hospital cardiopulmonary resuscitation (CPR) is associated with worse outcomes than intubation. DNR orders are more commonly implemented for older patients with more comorbid conditions regardless of the reason for hospitalization, [...]

Background: Advance care planning (ACP) is recommended to improve compliance with patient end-of-life wishes and to ensure appropriate use of healthcare resources. However, most American adults have neither living wills nor advance directives. Hospital physicians play a critical role in discussing and executing advance care plans, and stronger doctor-patient relationships may help increase rates of [...]

Background: High risk patients undergoing elective surgery are at increased risk of life-threatening complications. Also, most are under anesthesia, lacking capacity for at least that time. Despite this they often lack advance directives (ADs) or do not have them accessible in their medical records. Methods: We did a retrospective chart review of 231 patients seen [...]

Background: The MOLST form is a medical order that documents decisions about life-sustaining treatment made by patients with serious advanced illnesses. This performance improvement project aims to increase the number of MOLST forms completed in the Telemetry Unit on 9 South at Wyckoff Hospital. Methods: A virtual noon conference was conducted by Dr. Tanveer Mir [...]