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In order to systematically improve code status communication and documentation while clarifying how providers understand code status decisions, we propose the Choice of Diction's Effect Electronic Measures of Resuscitation Study Inpatient (CODE-EMRS.I) with 3 aims: Aim 1 - Determine rate of patient utilization of code status invitation (research) via the Portal (Hypothesis 1: Participants with an existing Portal are more likely to participate in research than new signups); Aim 2 - Evaluate different phrasings in code status prompts with and without death language (Hypothesis 2: Participants are more likely to pick no code with death language than without); Aim 3 - Determine how objective data drives physician agreement on code status decision (Hypothesis 3: Physicians are more likely to disagree with full code decisions for poor GO-FAR, but not CCI). Participants will fill out all study questionnaires electronically, but have options within these to ask to speak to a study physician/their own physician for clarification. After completing the surveys, the research associate will deliver the patient's code status decision to the attending of record and ask their views on it. Once a week, participants who have expressed interest in the study (by clicking the "I am interested" button) but have not completed the study will receive a reminder to complete the study as well as an offer to withdraw from the study in that same communication.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental/Death language | Experimental | Participants will be asked: The purpose of this trial is to understand how the words we use to describe CPR affect patient decisions. Cardiopulmonary resuscitation (CPR) is performed when the heart stops beating. It consists of electric shocks to the heart, pumping the chest to circulate blood, and using a breathing machine to help with breathing. The success rate of CPR is about 1 in 7, and even when the heart restarts, the brain and other organs can be damaged. If your heart were to stop beating and you were to die without resuscitation, would you prefer that we attempt cardiopulmonary resuscitation (CPR), or would you prefer that we do not resuscitate (DNR)? |
|
| Standard/non-death language | No Intervention | Participants will be asked: The purpose of this trial is to understand how the words we use to describe CPR affect patient decisions. Cardiopulmonary resuscitation (CPR) is performed when the heart stops beating. It consists of electric shocks to the heart, pumping the chest to circulate blood, and using a breathing machine to help with breathing. The success rate of CPR is about 1 in 7, and even when the heart restarts, the brain and other organs can be damaged. If your heart were to stop beating, would you prefer that we attempt cardiopulmonary resuscitation (CPR), or would you prefer that we do not resuscitate (DNR)? |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Death language | Behavioral | We will explicitly mention death when letting the participant know about CPR |
|
| Measure | Description | Time Frame |
|---|---|---|
| Code status decision | At enrollment | |
| Physician of record decision for and agreement with code status | Within 24 hours of patient decision |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Karthik J Kota, MD MPH | Contact | 732-235-7112 | karthik.kota@rutgers.edu |
| Name | Affiliation | Role |
|---|---|---|
| Karthik J Kota, MD MPH | Assistant Professor of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Robert Wood Johnson University Hospital - New Brunswick | Recruiting | New Brunswick | New Jersey | 08901 | United States |
De-identified individual participant data will be made available upon request to the Department of Medicine and approval of the data elements by appropriate regulatory elements in the Department
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