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Advance Care Planning in Primary Care

Title: Advance Care Planning in Primary Care: A Quality Improvement Project.
Name(s): Dennis, Amanda Lang, author
Type of Resource: text
Genre: Text
Research Report
Date Issued: 2018-04-12
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: Purpose of the Project: Advance care planning (ACP) has been shown to reduce unwanted care at end of life. However, rates of documentation of advance directives (ADs) are low in most settings. The aim of this project was to increase the number of ACP discussions that occur in a primary care clinic between provider and patient. Methods: The setting for this project was a family medicine residency program in a health system-owned practice, which included 20 resident physicians, six faculty physician providers and one advanced registered nurse practitioner (ARNP). The first phase was an evaluation of an educational program for providers on ACP with the goal of increasing provider willingness to engage in ACP. The second phase was a quality improvement (QI) initiative involving clinical and non-clinical staff in the primary care office, using the Plan-Do-Check-Act (PDCA) framework. Results: Through the initial stages of the PDCA, participants identified awareness of ACP among patients, staff, and providers to be the most important factor in improving rates of ACP. A month-long awareness campaign was initiated, with specific activities to promote ACP. No significant change was identified in the number of ADs scanned into the EMR or in the number of ACP procedure codes billed before and after initiation of the QI intervention. Discussion: Through the course of the QI initiative, participants recognized that both staff and provider education is essential in improving ACP. They also identified that more patient education and outreach is needed. An awareness campaign was successful in encouraging discussion of ACP and its importance, but did not have an overall impact on rates of ACP. Conclusions: Changing culture and attitudes about ACP requires a comprehensive, multi-level strategy to engage providers, staff, and patients.
Identifier: FSU_libsubv1_scholarship_submission_1523550044_6c0b0a2c (IID)
Persistent Link to This Record:
Host Institution: FSU

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Dennis, A. L. (2018). Advance Care Planning in Primary Care: A Quality Improvement Project. Retrieved from