Some organizations have managed to improve advance care planning despite limited resources and funding. For instance, New York's Coney Island Hospital found a volunteer who led a focused effort to improve advance care planning on one unit. Through his efforts, 13 health care proxy documents were completed in a two-month period.
Other ways to improve advance care planning include:
- Naming a health care proxy on all hospital consent forms, such as surgical consent forms
- Asking health insurance companies to ask enrollees to designate a health care proxy on the enrollment form
- Including the health care proxy on computerized databases and systemwide networks
- Starting a community living will project, a coalition of organizations to focus on living wills and increase public awareness of advance care planning
- Referring home health care patients to a social worker for end-of-life assessments and planning
- Establishing practices that enable doctors to write a patient's CPR preferences at the time of admission (e.g., over the phone)
- Establishing a timeframe within which Do Not Attempt Resuscitation orders will be explicitly discussed and the discussion documented in a patient's chart, after hospital or nursing facility admission
- Having a standardized location in the patient's record for documenting plans for emergency and end-of-life care (in addition to the advance directive), such as a vinyl pocket or a particular line on the problem list that refers to specific notes inside
- Distributing patient education brochures on advance care planning or making available instructional videotapes
- Implementing computerized reminder system on patient charts for outpatient clinic visits
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