Step by Step

INTRODUCTION

UPMC Altoona - Code Status Discussions for Hospitalists

QUIZ

EVALUATION

CERTIFICATE

INTRODUCTION

Credit Hours: CME 1.00

Target Audience:

Hospitalists, subspecialty physicians with admitting privileges, and Family Practice Residents at UPMC Altoona

Educational Objectives:

Upon completion of this activity, participants should be able to:

  • Perform an efficient and accurate Code Status Discussion on hospital admission
  • Explain the four abilities patients must have in order to have decision-making capacity
  • Describe how a surrogate decision-maker is determined in Pennsylvania
  • Properly document a quick Code Status Discussion in Powerchart

Suggested Additional Reading:

  1. Appelbaum, PS. Assessment of Patients' Competence to Consent to Treatment. N Engl J Med 2007; 357:1834-1840
  2. El-Jawahri A, Lau-Min K, Nipp RD, Greer JA, Traeger LN, Moran SM, D'Arpino SM, Hochberg EP, Jackson VA, Cashavelly BJ, Martinson HS, Ryan DP, Temel JS. Processes of code status transitions in hospitalized patients with advanced cancer. Cancer. 2017 Sep 7. doi: 10.1002/cncr.30969.
  3. Downar J, Hawryluck L. What should we say when discussing “code status” and life support with a patient? A Delphi analysis. J Palliat Med. 2010 Feb;13(2):185-95.
  4. Ebell MA et al, Development and Validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) Score to Predict Neurologically Intact Survival After In-Hospital Cardiopulmonary Resuscitation. JAMA Internal Medicine November 11, 2013 Volume 173, Number 20
  5. Mills L, Rhoads C, Curtis J. Upgrading the Admission Code Status Discussion: A Curriculum for Medical Trainees. MedEdPortal. 2015 10.15766/mep_2374-8265.10086
  6. Swayden KJ, Anderson KK, Connely LM, Moran SM, McMahon JK, Arnold, PM. Effect of sitting vs. standing on perception of provider time at bedside: A pilot study. Patient Education and Counseling 86 (2012) 166-171.
  7. Vettese T, Weinberger J, Thati N. “Do You Want Us to Do Everything?”: Teaching Residents to Discuss Resuscitation with Hospitalized Patients. MedEdPortal 2015 10.15766/mep_2374-8265.10122
  8. Yuen JK, Red MC, Felters MD. Hospital do-not-resuscitate orders: why they have failed and how to fix them. J Gen Intern Med. 2011 Jul:26(7):791-7.

Authors:
Jesse Blank, MD — Palliative Care Fellow, Altoona Family Practice Assistant Director, ALTNA-Altoona Family Physicians
No relationships with industry relevant to the content of this educational activity have been disclosed.
Authors disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above. No other planners, members of the planning committee, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity.

The University of Pittsburgh is an affirmative action, equal opportunity institution.