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Barriers and Strategies to an Iterative Model of Advance Care Planning Communication Public Deposited

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https://ir.library.oregonstate.edu/concern/articles/s1784n301

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  • Background: Early and repeated patient–provider conversations about advance care planning (ACP) are now widely recommended. We sought to characterize barriers and strategies for realizing an iterative model of ACP patient–provider communication. Methods: A total of 2 multidisciplinary focus groups and 3 semistructured interviews with 20 providers at a large Veterans Affairs medical center. Thematic analysis was employed to identify salient themes. Results: Barriers included variation among providers in approaches to ACP, lack of useful information about patient values to guide decision making, and ineffective communication between providers across settings. Strategies included eliciting patient values rather than specific treatment choices and an increased role for primary care in the ACP process. Conclusions: Greater attention to connecting providers across the continuum, maximizing the potential of the electronic health record, and linking patient experiences to their values may help to connect ACP communication across the continuum.
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  • Ahluwalia, S. C., Bekelman, D. B., Huynh, A. K., Prendergast, T. J., Shreve, S., & Lorenz, K. A. (2015). Barriers and strategies to an iterative model of advance care planning communication. American Journal of Hospice and Palliative Medicine, 32(8), 817-823. doi:10.1177/1049909114541513
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  • 32
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  • 8
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  • This work was supported by the Department of Veterans Affairs Comprehensive End-of-Life Care Initiative, Office of Patient Care Services. Dr Ahluwalia is supported in part by a Career Development Grant from the National Palliative Care Research Center. The preparation of this article was supported in part by the Implementation Research Institute (IRI), at the George Warren Brown School of Social Work, Washington University in St Louis, through the National Institute of Mental Health (R25 MH080916-01A2) and the Department of Veterans Affairs, Health Services Research & Development Service, Quality Enhancement Research Initiative (QUERI).
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  • description.provenance : Made available in DSpace on 2015-12-10T16:28:39Z (GMT). No. of bitstreams: 1 Ahluwalia SangeetaPublicHealthHumanSciBarriersStrategiesIterative.pdf: 315991 bytes, checksum: a8572717c1898e02438b090e7ce1000c (MD5) Previous issue date: 2015-12
  • description.provenance : Approved for entry into archive by Patricia Black(patricia.black@oregonstate.edu) on 2015-12-10T16:28:39Z (GMT) No. of bitstreams: 1 Ahluwalia SangeetaPublicHealthHumanSciBarriersStrategiesIterative.pdf: 315991 bytes, checksum: a8572717c1898e02438b090e7ce1000c (MD5)
  • description.provenance : Submitted by Patricia Black (patricia.black@oregonstate.edu) on 2015-12-10T16:28:12Z No. of bitstreams: 1 Ahluwalia SangeetaPublicHealthHumanSciBarriersStrategiesIterative.pdf: 315991 bytes, checksum: a8572717c1898e02438b090e7ce1000c (MD5)

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