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Updated: May 22, 2026

Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum

Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum

Published on: August 5, 2020

Implementing advance directives in office practice.

G David Spoelhof¹, Barbara Elliott

¹St. Luke's Hospital of Duluth, Duluth, MN, USA. dspoelho@d.umn.edu

American Family Physician

|April 27, 2012

Summary

This summary is machine-generated.

Advance directives help patients maintain autonomy. Effective strategies involve physician-patient communication, addressing barriers like time constraints and patient knowledge gaps, to ensure directives are completed and implemented.

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Area of Science:

Medical Ethics
Health Communication
Geriatric Medicine

Background:

Advance directives are crucial for patient autonomy during incapacity or end-of-life care.
State-specific documents exist, but effective implementation requires more than form completion in family practice.

Purpose of the Study:

To identify and analyze barriers to the completion and implementation of advance directives.
To explore strategies for overcoming these barriers within the family physician's office.

Main Methods:

Qualitative analysis of physician and patient barriers.
Review of strategies for effective advance directive completion and implementation.

Main Results:

Physician barriers include time constraints and topic discomfort.
Patient barriers involve lack of knowledge, fear of burdening family, and preference for physician-initiated discussions.
Implementation barriers include vague language, proxy issues, and accessibility.

Conclusions:

Overcoming barriers requires sustained, effective communication across multiple visits.
Early and ongoing family/proxy involvement is beneficial.
Integrating discussions into life stages and health changes aids the process.