*This recording is repurposed from the 2023 Annual Assembly

The Palliative Care (PC) team identified a need for standardized definitions for resuscitation in clinical practice. The Electronic Health Record (EHR) offered 14 options under Limited Code, leading to confusion with potential for futile or undesired resuscitation attempts. The PC team utilized change theories to address this issue in a large healthcare system. This large system included 17 hospitals, over 21,000 caregivers, and more than 100 physician clinics span. There is a lack of evidence in standardizing Limited Code orders in clinical practice. The PC team assessed the opportunity for change by analyzing case occurrence reports. Using Havelock’s theory of change, the PC team began with a determination of key interdisciplinary stakeholders. Collaborative meetings were held with team leads from critical care medicine, education, informatics, quality, safety, and legal. Buy-in was obtained and open dialogue occurred to determine appropriate resuscitation options with implementation strategies. These standardized definitions were elevated through multiple levels of review. Following policy approval, the PC team then led EHR modifications and developed educational materials for clinicians throughout the system. The Limited Code order was clearly delineated to a single, universal definition. Informal feedback from stakeholders and direct care clinicians was positive and accepting of the change. The modifications to the EHR were completed and as part of change theory, monitoring of the revisions is ongoing with retrospective chart reviews. All patients, regardless of health literacy or socioeconomic background, should be able to choose a medically sound code status in line with their wishes.