• Donna S Zhukovsky, Ali Haider, Janet L Williams, Syed Naqvi, Neeraj Joshi, Sarah Mills, Pamela T Soliman, Boby Mathew, Diane Bodurka, Larissa A Meyer, Shannon Westin, Michael Frumovitz, Marisa B Nowitz, LaShan Archie, Shauna Fenton, Kai Lang, Valentine Boving, and Eduardo Bruera.
• Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. Electronic address: dzhukovs@mdanderson.org.
• J Pain Symptom Manage. 2021 Jun 1; 61 (6): 130513101305-1310.

BackgroundWe implemented a systematic multidisciplinary process to engage new outpatients with cancer in selecting and preparing a medical decision-maker.MeasuresTemplated advance care planning notes and medical power of attorney documents were used in the electronic health record by the third office visit.InterventionPatients were coached to meet with social work from a "culture of yes," viewed a video about the importance of selecting a prepared medical a decision-maker in English or in Spanish, and referenced cards containing simple explanations of advance directives when responding to advance directive questions.OutcomesA total of 351 patients were evaluated. By visit 3, there was no increase in documented social work advance care planning notes in intervention or scanned medical power of attorney documents in the electronic health record.Conclusions/Lessons LearnedThis systematic multidisciplinary approach did not engage new outpatients with cancer in preparing a medical decision-maker. More active physician involvement and varied ways of engagement are needed.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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