Improving Advanced Care Planning Discussions at an Internal Medicine Clinic

Area of Science:

• Internal Medicine
• Public Health
• Gerontology

Background:

• Advanced care planning (ACP) is crucial for ensuring patient autonomy in medical decision-making.
• A significant gap exists in the documentation of advanced directives within clinical settings.
• Physician-patient communication is key to facilitating ACP discussions.

Purpose of the Study:

• To standardize advanced care planning (ACP) at an internal medicine clinic.
• To initiate physician-patient communication about advanced medical directives.
• To assess patient knowledge, understanding, and willingness to pursue advanced directives.

Main Methods:

• A pre-intervention survey assessed patient demographics, medical conditions, and prior exposure to advance directives.
• Standardized educational materials on advanced medical directives were provided to interested patients.
• A post-intervention survey evaluated the impact of education on ACP discussion comfort and likelihood of completion.

Main Results:

• Only 1.2% of patients possessed advanced directives prior to the intervention.
• Older patients and those with more comorbidities were more likely to have had prior ACP discussions.
• Standardized education significantly increased patient engagement and awareness regarding advanced directives.

Conclusions:

• A substantial deficit in advanced care planning documentation was identified.
• Targeted interventions are needed to encourage ACP, especially for younger patients and those with fewer comorbidities.
• Standardized educational resources are effective in promoting ACP discussions and engagement.