• Sara Brigham, Lori Olson, Jessica Kalender-Rich, Ben Skoch, Joanna Veazey Brooks, Casey Pickering, Dustin Pierce, Angella Herrman, Maritza Campos, Randa Hallock, and Karin Porter-Williamson.
• Division of Palliative Medicine (S.B., L.O., J.V.B., B.S., K.P.W), University of Kansas School of Medicine, Kansas City, Kansas, USA; Critical Care Division, Department of Nursing, The University of Kansas Health System (C.P.), Kansas City, Kansas, USA. Electronic address: sara.n.brigham@gmail.com.
• J Pain Symptom Manage. 2024 Sep 21.

BackgroundAdvance Care Planning (ACP) is critical to achieve goal-aligned care for patients. However, optimal implementation requires complex coordination and alignment across a healthcare system.MeasuresA survey of rapid response providers assessed usefulness of the ACP quality improvement bundle and perceptions of use and adherence.InterventionWe implemented a bundle of advance care planning tools and interventions using the technical-adaptive framework. These included orders, documentation templates and processes, and standard education.OutcomesNinety-three rapid response providers completed the survey. 80.5% reported that overall, these quality improvement efforts have been very helpful or somewhat helpful in improving their ability to provide care consistent with the patient's goals.Conclusions/Lessons LearnedImplementation of technical and adaptive tools as a bundle for Advance Care Planning shows promise to improve and sustain goal-aligned care. Quality Improvement in ACP is a complex, iterative process involving both structural change and behavioral adaptation.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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