Code status and resuscitation options in the electronic health record
Open accessAbstract
Aim The advance discussion and documentation of code-status is important in preventing undesired cardiopulmonary resuscitation and related end of life interventions. Code-status documentation remains infrequent and paper-based, which limits its usefulness. This study evaluates a tool to document code-status in the electronic health records at a large teaching hospital, and analyzes the corresponding data.Methods Encounter data for patients admitted to the Medical Center were collected over a period of 12 months (01-APR-2012-31-MAR-2013) and the code-status attribute was tracked for individual patients. The code-status data were analyzed separately for adult and pediatric patient populations. We considered 131,399 encounters for 83,248 adult patients and 80,778 encounters for 55,656 pediatric patients in this study.Results 71% of the adult patients and 30% of the pediatric patients studied had a documented code-status. Age and severity of illness influenced the decision to document code-status. Demographics such as gender, race, ethnicity, and proximity of primary residence were also associated with the documentation of code-status.Conclusion Absence of a recorded code-status may result in unnecessary interventions. Code-status in paper charts may be difficult to access in cardiopulmonary arrest situations and may result in unnecessary and unwanted interventions and procedures. Documentation of code-status in electronic records creates a readily available reference for care providers.
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The code status recorded for a patient is essential for guiding resuscitation in hospitals.
“This information, recorded in the patient's code status, is crucial for resuscitation management in hospitals.7”
From In-Hospital Code Status Updates: Trends Over Time and the Impact of COVID-19 (2024) · cites this paper as [7]
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In-Hospital Code Status Updates: Trends Over Time and the Impact of COVID-19
Sahebi-Fakhrabad, A., Kemahlioglu-Ziya, E., Handfield, R., Wood, S., Patel, M. D., Page, C. P., & Chang, L. (2024) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091231222188 · Cited by 2 · see citing works
- Authors
- Bhatia, H. L., Patel, N. R., Choma, N. N., Grande, J., Giuse, D. A., & Lehmann, C. U.
- Affiliations
- Vanderbilt University (US)
- Corresponding author
- Bhatia, Haresh L.
- Venue
- Resuscitation
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 87
- Pages
- 14-20
- ISSN
- 0300-9572 (ISSN-L)
- PMC
- PMC4293350
- OpenAlex
- W2023580012
- Cited by
- 35
- References
- 11
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 5 · 2021: 5 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 8 · 2016: 2 · 2015: 3
- FWCI
- 4.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Resuscitation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NLM (2T15 LM 007450)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- code status, electronic health records, advance directives, cardiopulmonary resuscitation, end-of-life care, documentation completeness, pediatric patients, adult patients, demographic disparities, cardiac arrest
- MeSH terms
- Adult, Child, Hospitals, Teaching, Humans, Patient Participation, Terminal Care, United States, Resuscitation Orders, Cardiopulmonary Resuscitation, Unnecessary Procedures, Advance Directive Adherence, Current Procedural Terminology, Electronic Health Records
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