Project: The Effect of a Quality Improvement Initiative to Promote Advance Care Planning in the Nursing Home Team: Washington, DC Veterans Affairs Medical Center: Joy Laramie, NP; Mary Ann Wentzel, MSW; Raya Kheirbek, MD; Susan Beale, Sammy Khatib Contact: raya.kheirbek@med.va.gov Aim: To Evaluate the Effectiveness of a QI effort on Advance Care Planning Documentation Partial List of Changes Made: Physician NH leaders developed a format for ACP documentation in the electronic medical record (EMR). ACP elements included: (1) healthcare decision-making capacity and (2) surrogate for healthcare decision-making, and (3) care preferences. Identification and placement of the completed ACP note located in an easily retrievable location in the EMR by any authorized provider. A method for updating ACP notes was also implemented. All NH physicians(MDs) and nurse practitioners(NPs) were trained in ACP development and documentation. Hospital cross-covering MDs were educated on the content and location of new ACP notes. Outcome Measures: Following the intervention, 100% of residents had ACP notes documented and 96% of ACP notes contained all three recommended elements. NH physicians and NPs all reported comfort in initiating ACP discussions and high satisfaction with the ease of documentation. On-call NH and hospital MDs also reported high satisfaction with ease of use and clarity the new ACP notes. Conclusion: QI methods can be used to improve: the rate of ACP documentation in the NH, communication between NH residents/families and NH/hospital providers, provider satisfaction. Future Plans: To assess the effects of ACP documentation in promoting patient/family care preferences, appropriate utilization of hospital/ICU care for NH residents, and patient/family satisfaction at the end of life. <top> << Back to QIC Project Index