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Updated: Sep 9, 2025
Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Health System Intervention to Innovate and Improve Advance Care Planning for Older Adults
Katherine Aragon1, Brian S Wood2, Karen Halpert3
1Department of Medicine (K.A., L.H.), University of North Carolina Palliative Care Program, Chapel Hill, North Carolina.
Background:
Advance care planning (ACP) conversations happen infrequently even for patients with serious illness. Because patients are seen across settings, a unified approach to ACP is important in large integrated health systems.
Measures:
To describe the structural and clinical process changes implemented by a large health system to improve and expand ACP for older adults.
Intervention:
UNC Health, a large academic public health system, created the ACP Taskforce to develop and implement a plan to document, facilitate, and educate to expand ACP across entities for patients 65 years and older.
Outcomes:
Between July 2019 to June 2022, the percentage of patients 65 years and older with any ACP documentation increased from 63% to 72.2%. ACP documentation shifted over that time to documenting health care decision makers and completing ACP notes.
Conclusion/Lessons Learned:
Aligning ACP across a large health system was facilitated by representation across entities and resulted in improved ACP practices.
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