TY - JOUR T1 - mHOMR: the acceptability of an automated mortality prediction model for timely identification of patients for palliative care JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 837 LP - 840 DO - 10.1136/bmjqs-2020-012461 VL - 30 IS - 10 AU - Stephanie Saunders AU - James Downar AU - Saranjah Subramaniam AU - Gaya Embuldeniya AU - Carl van Walraven AU - Pete Wegier Y1 - 2021/10/01 UR - http://qualitysafety.bmj.com/content/30/10/837.abstract N2 - Patients with non-cancer serious illnesses are under-recognised and receive palliative care only in the final weeks of life, if at all.1 The modified Hospitalised-patient One-year Mortality Risk (mHOMR) tool is a computer-based mortality prediction tool that accurately identifies patients at risk of 1-year mortality and is a feasible alternative to healthcare provider (HCP)-dependent models.2 Briefly, the tool uses data from the electronic health record to calculate an mHOMR score for each new hospital admission. The alert only notifies the lead physician, suggesting they refer the patient topalliative care and does not provide the actual score.2 In this study, we sought the perspectives of patients, family members, and HCPs to identify acceptability of mHOMR as a mortality risk tool. Together, these two studies represent the feasibility and acceptability components of the implementation outcomes (IO) framework.3 Previously we reported the development and feasibility of mHOMR (see Wegier et al 2 for more details). Alongside the feasibility study2 we collected qualitative data from November 2016 to May 2017 pre-implementation and from June to October 2017 post-implementation at two quaternary hospitals in Toronto, Canada. We used a postpositivist, qualitative content methodology4 and consecutively recruited: (1) English-speaking patients admitted to a medicosurgical ward with an mHOMR score >0.21 (ie, >21% risk of death in 12 months) and (2) HCPs who admitted patients with an mHOMR score >0.21 or were involved in advance care planning or goals of care (GOC) discussions with these patients. Substitute decision makers were recruited if a patient could not consent. In-person interviews with patients and caregivers and phone interviews with HCPs were … ER -