• Michelle A Leak, Elaine R Gustetic, Nancy P Ford, Launia J White, Jordan Rosedahl, Naveen Perisetla, Gabrielle Dozier, James M Naessens, and Catherine Madaffari.
• Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First St SW, Rochester, MN 55902. Email: naessens@mayo.edu.
• Am J Manag Care. 2021 Oct 1; 27 (10): e361-e364.

ObjectivesAdvance care planning (ACP) consults have been credited with increasing the likelihood that patients will receive desired care at the end of life, including reduced hospitalization and spending. We aimed to investigate whether implementation of ACP consults leads to improved advance directive (AD) completion rates.Study DesignRetrospective case-control evaluation.MethodsChart review was conducted among patients in hematology/oncology and primary care to compare AD completion rates of patients in each clinical area offered ACP consults between July 1, 2017, and June 30, 2018, and those not offered ACP consults prior to July 1, 2017.ResultsCompleted ADs increased from historic rates of 1% to 65.9% of primary care patient records. Among hematology/oncology patients offered consults, completed ADs were present in 28.1% of patient records compared with historic rates of 3%.ConclusionsPatients offered ACP consults had significantly higher AD completion rates than those without consults in both primary care and hematology/oncology practices. The difference in ACP consult attendance between the primary care and hematology/oncology groups clearly suggests that further improvements can be made to assist patients in accessing AD education and completion support.

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