The development of an ASCO-compliant, user-friendly electronic template to improve documentation and retrieval of advance care planning conversations: The approach of a community-based oncology practice.

Abstract

36 Background: Advance Care Planning (ACP) discussions are essential components of patient care. These conversations take place routinely in oncology settings, but their documentation is time consuming and difficult to extract. Methods: Blue Ridge Cancer Care (BRCC), is certified in the ASCO/COA APC4 pilot, planned to improve its documentation of ACP discussions, and took the initiative to create a succinct, user-friendly ACP template that could be documented electronically and easily extracted for data analysis. The ASCO requirements for ACP conversations were reviewed and applied to edit an ACP template created in compliance with the Joint Commission’s requirements for the advanced certification in Palliative Care. The new template was then presented to different groups of providers in the local practice and in the larger network that the practice is part of. Results: BRCC serves about 15,000 active patients a year, with 8, 000 new consults and a total of more than 70,000 visits. The documentation of ACP conversation at the beginning of the project was 76% (n=304). Over a period of 4 months (January-April 2023) the BRCC’s Quality Programs & Process Improvement team created the new ACP template and presented it at the monthly meeting of clinical providers in three different sites. The template was also presented at one of the monthly meetings of the US Oncology Palliative Care Team. Twenty-five feedbacks were collected. There were extensive conversations about the role of different level providers in performing and documenting the conversation, i.e. physicians, Advance Care Practice Providers (APP), social workers and Nurse Navigators. The feedback process resulted in 2 edits and 3 action plans. Interestingly, the compliance increased to 83% (n=622) during this period of time, likely due to increased awareness. The form will be implemented in the coming months and the report of the results will follow. Conclusions: The development of an efficient template to document ACP conversation requires extensive feedback from users, promotes insightful discussions and strengthens providers’ engagement to ensure sustainability.