28 | NEW KNOWLEDGE, INNOVATIONS, AND IMPROVEMENTS Facilitating Code Status Change Hospitalized patients present at medical inflection points where resuscitation status must be addressed or re-affirmed. Comprehensive serious illness, goals of care, advance care planning, and resuscitation status conversations are time-consuming and require a compassionate, experienced clinician to facilitate. The purpose of this study at Sharp Memorial Hospital was to describe relationships between Advanced Illness Management (AIM) consultations and code status. AIM nurses, who are specially trained nursing navigators, can facilitate code status, goals of care and other serious illness discussions, offloading the burden of these conversations from physicians and aligning care plans with individual patient goals. This retrospective, population-based observational cohort study included all adult patients admitted to inpatient or observation between October 2022 and January 2024 with an AIM consult. Outcome: AIM completed 3,967 consults or follow-ups on 3,342 admission events. Patients ranged in age from 18 to 106 years, with 88% being older than 65. Of the older adult patients, 60% arrived with a full code status. After consultation with AIM, 749 (36%) older adults de-escalated to a more limited code status. Early AIM consultation in the Emergency Department compared to consultation at any other point in the hospitalization was associated with a significantly shorter length of stay (3.5 days versus 7.5 days). Photo: (from left) Arlene Ferrer, BSN, RN, OCN, Supervisor, Sharp Memorial Hospital, Outpatient Infusion Center; Cory Kraft, BSN, RN, Advanced Clinician, Sharp Memorial Hospital, Outpatient Infusion Center; Kiecel Tungul, BSN, RN, Clinical Nurse, Sharp Memorial Hospital, Outpatient Infusion Center
