Increasing Advance Care Planning Completion at an Academic Internal Medicine Outpatient Clinic

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background We sought to increase advance care planning (ACP) completion at an academic internal medicine clinic through an electronic health record. Measures Number of eligible patients who completed a form of ACP. Intervention Multidisciplinary team approach with engagement from providers and clinic staff; implemented informational letter and appropriate forms to eligible patients before appointment; informational video and provider reminders at time of appointment. Outcomes Of 480 eligible patients, 327 (68%) completed one or more forms of ACP or had a discussion with their provider. Discussed but not completed was highest (53%). The three types of ACP completed were 1) a state-formatted advance directive form (47%), 2) Medical Orders for Life-Sustaining Treatment (45%), and 3) power of attorney designation (8%). Conclusions Implementation of a multi-disciplinary approach can facilitate ACP. However, challenges still arise because in more than half of the cases, advance care efforts led only to a discussion.

Original languageEnglish (US)
Pages (from-to)383-386
Number of pages4
JournalJournal of Pain and Symptom Management
Issue number3
StatePublished - Sep 2017


  • Advance care planning
  • advance directive
  • power of attorney

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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