The Common Sense Guide to Improving Palliative Care > Advance Care Planning > 3.7 Identifying and Testing Changes

Sick To Death book cover This extract from the online edition of The Common Sense Guide to Improving Palliative Care is used with permission.

Advance Care Planning: Identifying and Testing Changes

Team Delta

Once Team Delta finalized its aims and how to track them, it looked at best practices to identify good ideas to try on the study unit in order to improve advance care planning (ACP). The team decided to try the following ideas:

  1. Invite residents and families to attend a class that provides information on various options and helps them to complete ACP forms.
  2. Offer mandatory classes for clinicians to help them understand and initiate ACP discussions, including role playing.
  3. Involve frontline staff, such as admissions clerks, to get the advance directive forms completed and entered into the system.
  4. Develop a staff education and public awareness campaign within the facility to raise awareness, understanding, and recognition of the importance of ACP.
  5. Make ACP review part of the routine quarterly interdisciplinary team (IDT) meetings.
  6. Reach out to hospital partners to settle on standardized and adequate documentation and "transfer" procedures for ACP.

With the help and dedication of team members, Team Delta tried one change at a time. Once a strategy showed better results, they implemented it on a larger scale.

There are a number of ways that you can improve ACP for your patients. Here are some interventions that QI teams have tried and that have proven successful:

Change Ideas to Improve ACP

As you think about changes you would like to make, plan for obstacles. QI teams frequently encounter similar barriers, regardless of the setting in which they are working. Below is a list of common barriers; remember that others have overcome them—and you can, too:

Common Barriers to ACP

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