Outcomes of a 3-Year Quality Improvement Study to Improve Advance Care Planning in Patients With Decompensated Cirrhosis

Arpan Patel, Chip A. Bowman, Nicole Prause, Saikiran M. Kilaru, Andrew Nguyen, Nina Kogekar, Cynthia Cohen, Lindsay Channen, Alyson Harty, Ponni Perumalswami, Douglas Dietrich, Thomas Schiano, Christopher Woodrell, Ritu Agarwal

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: To report outcomes of a 3-year quality improvement pilot study to improve advance directive (AD) completion. METHODS: The pilot consisted of champions, education, electronic health record templates, and workflow changes. We assessed changes, predictors, and effects of AD completion. RESULTS: The pilot led to greater (8.3%–36%) and earlier AD completion, particularly among those divorced, with alcohol-associated liver disease, and with higher Model of End-Stage Liver Disease–Sodium score. Decedents whose AD specified nonaggressive goals experienced lower hospital lengths of stay. DISCUSSION: Advance care planning initiatives are feasible and may reduce health care utilization among decedents requesting less aggressive care.

Original languageEnglish
Pages (from-to)580-583
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume119
Issue number3
DOIs
StatePublished - 1 Mar 2024

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