The Common Sense Guide to Improving Palliative Care > Advance Care Planning > 3.2 About "Team Delta"
This chapter will help you meet challenges by describing quality improvement (QI) projects that work. The story of Team Delta's project to improve advance care planning (ACP) is based on a composite of several successful teams.
Team Delta is in a long-term care facility in a major city. About 20% of residents died each year. The facility had many ongoing QI programs, but nothing aimed at medical decision-making at the end of life. Team members had seen too many dying patients whose families insisted on tube feeding and hydration, even when doctors explained why these treatments would not be beneficial. Family members and staff agonized over what to do, especially when the resident could not communicate. Families and physicians were left trying to puzzle out what would be best. The team wanted a better way to prepare patient, families, and staff for these situations. They wanted to try a more organized approach to medical decision-making and ACP, including ways to update records as treatment preferences changed.