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
Hammes, Bernard J
Rooney, Brenda L
Gundrum, Jacob D
Journal of the American Geriatrics Society 2010 Jul; 58(7): 1249-55
OBJECTIVES: To determine whether outcomes have changed over time for a managed, systematic approach to advance care planning (ACP). DESIGN: Retrospective comparison of medical record and death certificate data of adults who died over a 7-month period in 2007/08 with those of adults who died over an 11-month period in 1995/96. SETTING: All healthcare organizations in La Crosse County, Wisconsin. PARTICIPANTS: Five hundred forty adults who died in 1995/96 and 400 adults who died in 2007/08. INTERVENTION: A systematic ACP approach, Respecting Choices, collaboratively implemented in 1993 and continuously improved in subsequent years. MEASUREMENTS: Demographic and cause-of-death data were collected from death certificates. Type and content of any advance directive (AD), existence and content of Physician Orders for Life-Sustaining Treatment, and medical treatment provided at the location of death in the last 30 days of life were abstracted from the medical record. RESULTS: The recent data show a significantly greater prevalence of ADs (90% vs 85%, P=.02) and of availability of these directives in the medical record at the time of death (99.4% vs 95.2%, P
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Death and End-of-Life Planning in One Midwestern Community Hammes, Bernard J.; Rooney, Brenda L. (1998-02-23)BACKGROUND: The major health care organizations in a geographically defined area implemented an extensive, collaborative advance directive education program approximately 2 years prior to this study. OBJECTIVES: To determine ...