Article ; Online: A Letter to Your Care Providers: Implementation and Analysis of a Letter-based Advance Care Planning Initiative for Gynecologic Oncology Patients.
Journal of cancer education : the official journal of the American Association for Cancer Education
2022 Volume 38, Issue 3, Page(s) 963–970
Abstract: To determine the impact of a letter-based advance care planning (ACP) healthcare improvement (HI) initiative on rates of ACP conversations and documentation among gynecologic oncology (GO) inpatients. An HI initiative was implemented from January to ... ...
| Abstract | To determine the impact of a letter-based advance care planning (ACP) healthcare improvement (HI) initiative on rates of ACP conversations and documentation among gynecologic oncology (GO) inpatients. An HI initiative was implemented from January to December 2020 to improve ACP documentation among GO inpatients. Patients admitted to the GO service were given ACP packets with a letter-based ACP worksheet. GO inpatients who were interested in learning more about ACP were visited by medical students trained to lead ACP conversations. ACP documentation rates in the EMR (electronic medical record) pre- and post-intervention were evaluated. Descriptive statistics were calculated. Associations between sociodemographic characteristics and ACP documentation were analyzed using logistic regression. There were 172 patients admitted in 2019 (pre-implementation cohort). Of these, 45/172 patients (26%) had an advance directive (AD) documented in their electronic medical record (EMR). Following the implementation of the ACP HI in 2020, 55/168 patients (33%) had an AD documented in their EMR. This was a 7% absolute increase and 27% relative increase from pre-intervention AD documentation rates. Increasing age was associated with an increased likelihood of having an AD in the chart (p = 0.004). Married women were less likely to have an AD in their chart (p = 0.05). An HI utilizing a letter-based ACP packet given to GO inpatients improved AD documentation in the EMR. This HI offers a unique method for introducing ACP to patients. More work is needed to improve the occurrence and documentation of ACP conversations. |
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| MeSH term(s) | Humans ; Female ; Genital Neoplasms, Female/therapy ; Advance Care Planning ; Advance Directives ; Patients ; Communication ; Documentation/methods | |||||
| Language | English | |||||
| Publishing date | 2022-08-24 | |||||
| Publishing country | England | |||||
| Document type | Journal Article ; Research Support, N.I.H., Extramural | |||||
| ZDB-ID | 632898-2 | |||||
| ISSN | 1543-0154 ; 0885-8195 ; 1543-1154 | |||||
| ISSN (online) | 1543-0154 | |||||
| ISSN | 0885-8195 ; 1543-1154 | |||||
| DOI | 10.1007/s13187-022-02214-3 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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