In this single center cohort of 100 patients in an ICU, the patients, families, and physicians were interviewed about the patients code status and goals of care, and the medical record was reviewed to determine what was reflected in the medical chart documentation. Only half of the patients/families recalled having a discussion about code status, and 83% preferred to be full code; overall the patient/family prediction of survival of a code was 72%, and there was a 16% discrepancy between the family/patient understanding of code status and what was documented in the medical chart. In addition, 2/3 of families/patients did not agree with the physician in the most important goals of care. We have a long way to go in helping patients/families and physician come to a common understanding of code status, code outcomes, and goals of care (abstract)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.