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Increasing Medical Power of Attorney Completion for Hospitalized Patients During the COVID Pandemic: A Social Work
Sarguni Singh1, Katie Herrmann2, Wendy Cyriacks3
1Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Background:
The high risk of mechanical ventilation with COVID hospitalizations requires health-care systems to rapidly innovate advance care planning (ACP) delivery for hospitalized patients to promote goal-concordant care.
Measures:
Assess the impact of a social work and care management intervention on the proportion of admitted patients each week with a Medical Durable Power of Attorney (MDPOA).
Intervention:
Social workers were consulted to assist with identification of a surrogate decision maker and completion of MDPOA forms for hospitalized patients. This intervention utilized change management strategies and was implemented between April and June 2020.
Outcomes:
From a baseline average of 30.1%, the weekly percentage of admitted patients with MDPOA forms rose to 42.8% with correlating evidence of nonrandom special cause variation.
Lessons Learned:
Use of change management strategies resulted in rapid implementation of an effective ACP initiative. Ongoing needs include focusing on intervention sustainability and education of interprofessional providers about ACP processes.
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