Quality conversations regarding healthcare decisions are a central tenant of patient-and-family-centered care, particularly for patients living with advanced illness. These conversations can reduce anxiety, improve quality of life, and help to support families throughout the disease trajectory. There are advantages to the patient, family, multidisciplinary team, and healthcare system for having early and advance care planning conversations.1-4
Advance care planning is central to quality care.² Advance care planning has been shown to increase the satisfaction of patients and families and help align medical delivery with patient preferences.6
Advanced care planning is a process. It should be fluid enough to narrow or widen its focus and direction for treatment choices as needed. Ideally, Advance care Planning would readily encompass healthy individuals and help prepare both the patient and their chosen surrogate to make decisions, not just for life prolonging medical decisions but also for the more routine medical decisions required in chronic and serious illness.²
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- Institute of Medicine of the National Academies; Committeeon Approaching Death: Addressing Key End-of-Life Issues. Dying in America: improving quality and honoring individual preferences near the end of life. Washington, DC: National Academies Press; 2015. https://www.nap.edu/catalog/18748
- Bernacki, R., Block, S.D.; Communication about serious illness care goals: A review and synthesis of best practices, for the American College of Physicians High Value Care Taskforce (2014). JAMA Internal Medicine174 (12), 1994-2003.
- Detering, K. M., Hancock AD, Silvester W.(2010). The impact of advance care planning on end of life care in elderly patients: randomized controlled trial. BMJ, 340; c1345.
- Leung, J.M., Udris, E.M., Uman, J., Au, D.H. (2012) The effect of end of life discussions on perceived quality of care and health status among patients living with COPD. Chest 142(1), 128-133.
- National Healthcare Decisions Day. Retrieved 7.21.16 at: http://www.nhdd.org/about/#about-us
- Hammes BJ, Rooney BL Gundrum JD. A comparative retrospective, observational study of the prevalence, availability, and specificity of advance care plans in a county that implemented an advance care planning microsystem. J AM Geriatr Soc 2010;58:1249-1255.