• Kristin Stawiarski, Gini Priyadharshini Jeyashanmugaraja, Kristin Edwards, Gloria Bindelglass, and Gilead Lancaster.
• Section of Cardiovascular Medicine, Yale New Haven Health Bridgeport Hospital, Bridgeport, CT. Electronic address: kristin.stawiarski@bpthosp.org.
• J Pain Symptom Manage. 2021 Dec 1; 62 (6): 1289-1294.

BackgroundCode status (CS) orders lack a universal definition. We aimed to improve provider understanding of order options.MeasuresProvider's knowledge of CS terminology, ease of understanding CS orders and ease of starting CS discussions.InterventionA multifaceted intervention including 1) altered CS order language in the electronic medical record (EMR) from "Full Interventions," "Limited Interventions," and "Comfort Measures Only" to "Full advanced cardiovascular life support (ACLS)," "Partial ACLS," and "No ACLS" 2) clinical tools for CS identification 3) provider education.OutcomesCorrect provider response rate for "Partial ACLS" and "No ACLS" terms increased from 43.5 to 60% and 20 to 71% (odds ratio 1.95; 95% confidence interval 0.99-3.83; P = 0.03, OR 9.8; CI 4.48-21.49; P < 0.001). The proportion of providers who felt understanding CS orders and starting conversations about CS was "very easy" (a score of 1-3 on a scale of 1 to 10) improved from 26.1 to 45.7% (P = 0.01) and 49.3 to 65.7% (P = 0.03).Conclusions/Lessons LearnedProvider understanding of CS options can be improved with a combined QI intervention.Copyright © 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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