• Ngoc-Phuong Luu, Candace Nigrin, Kimberly Peairs, Sydney M Dy, Melinda Sawyer, Samantha Pitts, and Brent Petty.
• Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address: Nluu3@jhmi.edu.
• J Pain Symptom Manage. 2017 Sep 1; 54 (3): 383-386.

BackgroundWe sought to increase advance care planning (ACP) completion at an academic internal medicine clinic through an electronic health record.MeasuresNumber of eligible patients who completed a form of ACP.InterventionMultidisciplinary 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.OutcomesOf 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%).ConclusionsImplementation 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.Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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