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Article ; Online: Evolving Advance Care Planning in a Health Ecosystem: The Kaiser Permanente Experience.

Ngo, Jason / Le, John / Gandhi, Chirag H / Mariano, Jeffrey D / Viveros, Lori A / Wang, Susan E

Journal of pain and symptom management

2023  Volume 66, Issue 2, Page(s) e245–e253

Abstract: Background: Advance care planning is an integral part of supporting patients through serious illness and end-of-life care.: Problem: Several components of advance care planning may be too inflexible to account for patients' changing disease and ... ...

Abstract Background: Advance care planning is an integral part of supporting patients through serious illness and end-of-life care.
Problem: Several components of advance care planning may be too inflexible to account for patients' changing disease and evolving goals as serious illness progresses. Health systems are starting to implement processes to address these barriers, though implementation has varied.
Proposed solution: In 2017, Kaiser Permanente introduced Life Care Planning (LCP), incorporating advance care planning dynamically into concurrent disease management. LCP provides a framework for identifying surrogates, documenting goals, and eliciting patient values across disease progression. LCP provides standardized training to facilitate communication and utilizes a centralized section within the electronic health record for longitudinal documentation of goals.
Outcomes: More than 6000 physicians, nurses, and social workers have been trained in LCP. Over one million patients have engaged in LCP since its inception, with over 52% of patients age 55+ having a surrogate designated. There is evidence of high treatment concordance with patients' desired wishes (88.9%), with high rates of advance directive completion as well (84.1%).
MeSH term(s) Humans ; Middle Aged ; Ecosystem ; Advance Care Planning ; Terminal Care ; Advance Directives ; Electronic Health Records
Language English
Publishing date 2023-04-11
Publishing country United States
Document type Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID 639142-4
ISSN 1873-6513 ; 0885-3924
ISSN (online) 1873-6513
ISSN 0885-3924
DOI 10.1016/j.jpainsymman.2023.03.008
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