Increasing Advance Care Planning Discussions and Documentation.

Area of Science:

• Oncology
• Palliative Care
• Health Informatics

Background:

• Advance care planning (ACP) is crucial for oncology patients, improving outcomes and reducing end-of-life care costs.
• Effective ACP enhances patient-centered care and aligns treatment with patient values.

Purpose of the Study:

• To increase advance care planning (ACP) discussions and documentation for hematologic malignancy patients at high risk of mortality.
• To integrate a mortality prediction model to identify at-risk patients for timely ACP interventions.
• To assess the impact on provider workflow and minimize perceived disruption.

Main Methods:

• Utilized a validated mortality prediction model to identify at-risk patients.
• Implemented a notification system for providers to initiate ACP discussions and standardized documentation.
• Conducted retrospective chart reviews to evaluate ACP documentation rates before and after a provider education session.
• Administered a provider survey to assess workflow disruption.

Main Results:

• A total of 15 at-risk patients were identified over 8 months.
• ACP documentation rates were 37.5% before and 42.9% after the education session, a non-significant increase.
• Despite the lack of statistical significance, 43% of at-risk patients had documented ACP post-education.
• 83% of providers reported no significant workflow disruption, finding the documentation method efficient.

Conclusions:

• The project achieved provider buy-in for advance care planning (ACP) documentation.
• The standardized 'bookend' documentation format is perceived as efficient by providers.
• Continued implementation of ACP documentation is recommended, despite the need for further evaluation with larger patient cohorts.