Availability of Advance Care Planning Documentation for Older Emergency Department Patients: A Cross-Sectional Study

Timothy F. Platts-Mills, Natalie L. Richmond, Eric M. Lefebvre, Sowmya A. Mangipudi, Allison G. Hollowell, Debbie Travers, Kevin Biese, Laura C. Hanson, Angelo E. Volandes

Research output: Research - peer-reviewArticle

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Abstract

Introduction: Increasing advance care planning (ACP) among older adults is a national priority. Documentation of ACP in the electronic health record (EHR) is particularly important during emergency care. Objective: We sought to characterize completion and availability of ACP among a subset of older patients at an academic emergency department (ED) with an integrated EHR. Methods: In this cross-sectional study, patients were eligible if aged ≥80 years or aged 65-79 with ≥1 indicator of high risk for short-term mortality. Patient-reported completion of ACP and availability of ACP documentation in the EHR were assessed. Results: Among study patients (n = 104), 59% reported completing some form of ACP: living will 52%, heathcare power of attorney 54%, do not resuscitate 38%, and medical orders for scope of treatment or physician orders for life-sustaining treatment 6%. Whites were more likely to report having some form of ACP than minorities (66% vs. 37%, p < 0.01), as were patients aged ≥80 years than those aged 65-79 (79% vs. 44%, p < 0.01). Only 13% of all patients had either a current code status or any other current ACP documentation in the EHR. Among patients whose primary care provider uses the same EHR system as the study ED, only 19% had a current code status or any other ACP documentation in the EHR. Conclusion: In a sample of older ED patients likely to benefit from ACP, few patients had documented end-of-life care preferences in the EHR.

LanguageEnglish (US)
Pages74-78
Number of pages5
JournalJournal of Palliative Medicine
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2017

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Advance Care Planning
Documentation
Hospital Emergency Service
Cross-Sectional Studies
Electronic Health Records
Therapeutics
Living Wills
Lawyers
Terminal Care
Emergency Medical Services
Primary Health Care
Physicians
Mortality

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)
  • Anesthesiology and Pain Medicine

Cite this

Platts-Mills, T. F., Richmond, N. L., Lefebvre, E. M., Mangipudi, S. A., Hollowell, A. G., Travers, D., ... Volandes, A. E. (2017). Availability of Advance Care Planning Documentation for Older Emergency Department Patients: A Cross-Sectional Study. Journal of Palliative Medicine, 20(1), 74-78. DOI: 10.1089/jpm.2016.0243

Availability of Advance Care Planning Documentation for Older Emergency Department Patients : A Cross-Sectional Study. / Platts-Mills, Timothy F.; Richmond, Natalie L.; Lefebvre, Eric M.; Mangipudi, Sowmya A.; Hollowell, Allison G.; Travers, Debbie; Biese, Kevin; Hanson, Laura C.; Volandes, Angelo E.

In: Journal of Palliative Medicine, Vol. 20, No. 1, 01.01.2017, p. 74-78.

Research output: Research - peer-reviewArticle

Platts-Mills, TF, Richmond, NL, Lefebvre, EM, Mangipudi, SA, Hollowell, AG, Travers, D, Biese, K, Hanson, LC & Volandes, AE 2017, 'Availability of Advance Care Planning Documentation for Older Emergency Department Patients: A Cross-Sectional Study' Journal of Palliative Medicine, vol 20, no. 1, pp. 74-78. DOI: 10.1089/jpm.2016.0243
Platts-Mills TF, Richmond NL, Lefebvre EM, Mangipudi SA, Hollowell AG, Travers D et al. Availability of Advance Care Planning Documentation for Older Emergency Department Patients: A Cross-Sectional Study. Journal of Palliative Medicine. 2017 Jan 1;20(1):74-78. Available from, DOI: 10.1089/jpm.2016.0243
Platts-Mills, Timothy F. ; Richmond, Natalie L. ; Lefebvre, Eric M. ; Mangipudi, Sowmya A. ; Hollowell, Allison G. ; Travers, Debbie ; Biese, Kevin ; Hanson, Laura C. ; Volandes, Angelo E./ Availability of Advance Care Planning Documentation for Older Emergency Department Patients : A Cross-Sectional Study. In: Journal of Palliative Medicine. 2017 ; Vol. 20, No. 1. pp. 74-78
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