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Published on: January 20, 2019
Advance Care Planning Bundle: Using Technical and Adaptive Solutions to Promote Goal Concordant Care
Sara Brigham1, Lori Olson2, Jessica Kalender-Rich3
1Division of Palliative Medicine (S.B., L.O., J.V.B., B.S., K.P.W), University of Kansas School of Medicine, Kansas City, Kansas, USA; Critical Care Division, Department of Nursing, The University of Kansas Health System (C.P.), Kansas City, Kansas, USA.
Background:
Advance Care Planning (ACP) is critical to achieve goal-aligned care for patients. However, optimal implementation requires complex coordination and alignment across a healthcare system.
Measures:
A survey of rapid response providers assessed usefulness of the ACP quality improvement bundle and perceptions of use and adherence.
Intervention:
We implemented a bundle of advance care planning tools and interventions using the technical-adaptive framework. These included orders, documentation templates and processes, and standard education.
Outcomes:
Ninety-three rapid response providers completed the survey. 80.5% reported that overall, these quality improvement efforts have been very helpful or somewhat helpful in improving their ability to provide care consistent with the patient's goals.
Conclusions/Lessons Learned:
Implementation of technical and adaptive tools as a bundle for Advance Care Planning shows promise to improve and sustain goal-aligned care. Quality Improvement in ACP is a complex, iterative process involving both structural change and behavioral adaptation.
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