Abstract 12778: Improving Advanced Care Planning for Hospitalized Patients With Heart Failure

Abstract

Introduction: Advanced Care Planning (ACP) is an important and proven strategy to improve end-of-life communication and the quality of life of patients with heart failure and their relatives. However, the frequency of ACP conversations in practice remains low. UCI’s heart failure (HF) metrics show that in the months of April 2021 to October 2021 prior to intervention, an average of 13.24% of HF patients hospitalized at UCI had completed ACP at discharge, as measured by presence of POLST form or Advanced Directive (AD) in Epic. The goal of this quality improvement project was to determine whether the rate of ACP completion could be improved using electronic medical record (EMR) reminders to the healthcare team. Methods: For a 3-month period [January 2022-March 2022], our research team messaged providers designated as ‘First Call’ for each hospitalized patient with a primary diagnosis of HF and no existing ACP documentation in the Epic EMR. Messages were sent via Epic’s secure chat function, serving as a reminder to complete ACP documentation including a POLST form. Messages were sent on the day of admission with a second message sent after 2 weeks if the patient remained hospitalized and there was no change in ACP completion status. Percentage of ACP documentation completion was calculated during the 3-month study period. Results: Our results have demonstrated that the ACP completion was an average of 21.00% during the 3 months of the intervention. This is a 7.76% absolute increase in ACP completion compared to 3 months prior to our intervention (13.24%); a 58.61% relative increase. Conclusions: ACP among hospitalized HF patients remains low. Direct message reminders to providers serves as a beneficial means of improving ACP completion among this subset of patients.