Abstract
Advance care directives outline the care decisions family and providers are to follow in end of life care. End of life care is often a topic that patients and providers do not typically spend time discussing. The purpose of this quality improvement project was to implement an educational program in a rural primary care setting about advanced directives. This project encompassed two specific aims: 1) to educate primary care providers and to provide an avenue for the initiation of a discussion about advances directives with their patients, and 2) to educate patients and to provide a means to communicate their needs with their primary care provider. Providers were interviewed to identify barriers to end of life discussions. Additionally, an advance care directive brochure, was distributed to patients to enhance dialogue between providers and patients. The caring and dialogue theory was utilized in this quality improvement project. Advance directive completion improved with the use of brochures and caring and dialogue theory implementation. Provider surveys revealed a great need for implementation of a program to improve advance directive completion, lack of time and patients not being ready to discuss advance directives were the top cited barriers.