Abstract
Family practice is a setting that focuses on caring for each patient throughout their lifespan. Advance care planning (ACP) is the communication process and plan for people when they can no longer make health care decisions. This is an important discussion to have in the primary care setting. Unfortunately, often the discussion for ACP is held in the emergency room or the Intensive Care Unit (ICU) during an acute patient event. Having ACP discussions in primary care settings ensures that families are better prepared for future health care decisions. The purpose of this quality improvement project was to increase ACP conversations between primary care providers and patients in an effort to improve ACP discussion, documentation, and staff access to ACP in the chart. The methods included notifying all patients with medical wellness exams prior to appointments with a letter containing information on ACP options. This initiated questions for patients to ask their provider during their well patient appointment. After eight weeks the charts were re-evaluated for the number of patients with ACP listed as part of their patient chart. For sustainability, this project was completed with a senior provider in the clinic and the handouts provided were like paperwork given in the attached hospital. It was found that all six patients who received letters now had information documented in their charts on ACP. Of the patients who received paperwork at least two out of six planned to update their living wills and bring the new information into the clinic. In conclusion, providing information to the patients allowed the patients the opportunity to be prepared with any questions on a difficult topic and was a reminder to update ACP paperwork. ACP is an important conversation and by increasing ACP discussions providers can improve end of life care for their patients.