End-of-Life Care Issues | AHRQ Innovations Exchange

End-of-Life Care Issues | AHRQ Innovations Exchange


End-of-Life Care Issues

Seriously ill or very elderly patients often cannot express their wishes because of limited mental or physical capabilities, leading to health care decisions that may be inconsistent with their wishes. Although advance care planning—a shared decisionmaking process about future health care choices—can help, many patients fail to engage in such planning; this may be true more often in minority populations. In addition, State policies can either facilitate or hinder the provision of effective, compassionate end-of-life care.

The featured Innovations describe three programs that aimed to increase rates of advance care planning. The programs include one that provided education and trained nonphysician facilitators to guide patients and their families in advance care planning; another in which a State-mandated council focused on end-of-life policy issues; and third in which care coordinators used a culturally sensitive, tailored approach to discuss advance care directives with seniors.

The featured QualityTools include a program and a Web site that offer resources to help people make informed decisions about end-of-life care and services, as well as a program that offers health care professionals the tools, training, and technical assistance necessary to start successful palliative care programs.

Featured Innovations:

•  Care Coordinators Engage in Culturally Sensitive Discussions About Advance Directives With Seniors, Increasing Completion Rates and Reducing Disparities Between African Americans and Whites

•  Community-Wide Education, Trained Facilitators, and Improved Processes Lead to More Advance Care Planning, Consistency Between Plans and End-of-Life Decisions, and Low Care Costs

•  Legislatively Mandated, Permanent Council Serves as Effective Catalyst for Sustained Progress on End-of-Life Policy Issues in Maryland

Featured QualityTools:

• Caring Connections: Brochures
Developed by National Hospice and Palliative Care Organization

• Hoag End of Life Care
Developed by Hoag Memorial Hospital Presbyterian

• Tools for Palliative Care Programs
Developed by Center to Advance Palliative Care

Featured Articles:

• National Initiative Uses Medical Order Forms To Translate Patients’ End-of-Life Wishes Into Action