The following is a summary of “Communication Training and Code Status Conversation Patterns Reported by Emergency Clinicians,” published in the January 2023 issue of Pain Management by Prachanukool, et al.
The level of end-of-life care is frequently decided by emergency doctors during acute health decompensations for very ill patients. Particularly among those who have undergone critical illness communication training, little was known about how emergency doctors held the interactions. For a study, researchers sought to identify the self-reported practice habits of emergency doctors with and without serious disease communication training in code status interactions.
Emergency physicians with and without recent evidence-based, critical disease communication training designed specifically for emergency doctors were the subjects of a cross-sectional survey. There were emergency medical specialists from two academic medical facilities. In order to evaluate the self-reported likelihood of inquiring about patients’ choices for medical treatments as well as patients’ values and aims, a five-point Likert scale (from “extremely unlikely” to “very likely” to inquire) was utilized.
About 77 (48%) responders out of 161 (71% response rate) received the training. Only 38% of emergency doctors reported inquiring about the patient’s end-of-life care values, whereas 70% reported asking procedure-based questions. Four of the seven value-based questions revealed statistically significant differences between emergency practitioners who received the training and those who did not (e.g., a higher likelihood of examining the patient’s life priorities [adjusted OR = 4.34, 95% CI = 1.95-9.65, P-value< 0.001]). There was no difference in the self-reported rates for any procedure-based items between the two groups.
The majority of emergency room doctors said they inquired about patients’ procedures- and value-based inquiries. Recent serious illness communication training might lead some clinicians to probe further into particular values and priorities.