Advance Care Planning: Improving the Conversation

Advance care planning is a critical element of wellness for all adult patients, regardless of diagnosis or health status. Too often, conversations concerning end-of-life care are completed under the stress of a medical crisis or not at all. When advance directives are created, they are often unclear or unavailable to those who need access. Given the low percentage of advance directives on file in the health system's medical records, it was important to improve the process for educating staff and community members about the importance of advance care plans and increase opportunities for completing not just advance directives, but also the conversations that should accompany them.

The health system has implemented a systemwide advance care planning improvement initiative to expand education and standardize processes for increasing the quality and quantity of advance directives on file. Goals include meeting community requests for education, increasing the number of advance care planning conversations, increasing the number of advance directives in electronic medical records and increasing advance directive conversations with staff. The health system is midway through implementation and is seeing great enthusiasm for the program.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/