Background: Conducting early serious illness conversations (SICs) is a high-value intervention that improves the patient and family experience while aligning care with patient preferences. Given the constraints of hospital-based clinicians, using the EHR to identify appropriate patients for SICs remains a key challenge. The aims of this study were to explore whether the EHR’s readmission [...]

Background: Despite benefits of early Serious Illness Conversations (SICs), including increased satisfaction and earlier hospice referral, rates of SICs remain low. The primary aim of this study is to assess if standardized documentation of SICs increase following implementation of interventions for providers to have more of these conversations with patients admitted to a general medicine [...]

Background: Identifying patients who may benefit from a Serious Illness Conversation (SIC) in the hospital is an important step in increasing SIC timeliness. Epic’s Readmission Risk Score (RRS) is an electronic health record integrated composite score (0-100%) that includes diagnostic, laboratory, medication, order, and utilization variables to predict unplanned, 30-day readmission and was found by [...]

Background: Hospitalized patients who are at high-risk for mortality and readmission represent a unique population requiring tailored interventions to improve care outcomes. Advance care planning (ACP) conversations in the inpatient setting can help align care goals with patient preferences, yet their influence on measurable clinical outcomes in this vulnerable population is not well understood. Methods: [...]