ArticleCureus2025
Improving the Use of Treatment Escalation Plans in Geriatric Medicine: A Quality Improvement Project.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Treatment escalation plans (TEPs) support patient-centered decision-making by documenting individualized goals of care during clinical deterioration. Despite national guidance, TEP completion remains inconsistent, particularly in geriatric medicine, where frailty and multimorbidity complicate escalation decisions. Our audit aims to improve the uptake and timeliness of TEP completion in geriatric medicine wards of a tertiary hospital in Glasgow through targeted quality improvement interventions. Methodology A two-cycle quality improvement project was conducted between April and August 2025. Only patients admitted during the study periods and meeting predefined TEP criteria were included. Interventions included a paper-based admission checklist (Cycle 1) and a multidisciplinary teaching program (Cycle 2). Outcome measures included TEP completion rates, time to documentation, decisions regarding Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), and consultant involvement. Results A total of 275 patients were included (baseline: 75; Cycle 1: 75; Cycle 2: 125). TEP completion rates improved from 21 of 75 patients (28%) at baseline to 32 of 75 (43%) in Cycle 1 and 72 of 125 (58%) in Cycle 2. Median time to TEP documentation decreased from 10.5 days (interquartile range (IQR) 7-14) to 5 days (IQR 3-8). DNACPR documentation increased from 55% to 73%, with a significant association between DNACPR completion and TEP completion (
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