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

doi:10.14309/ajg.0000000000002570

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 journal › Article › peer-review

5 Scopus citations

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 language	English
Pages (from-to)	580-583
Number of pages	4
Journal	American Journal of Gastroenterology
Volume	119
Issue number	3
DOIs	https://doi.org/10.14309/ajg.0000000000002570
State	Published - 1 Mar 2024

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Patel, A., Bowman, C. A., Prause, N., Kilaru, S. M., Nguyen, A., Kogekar, N., Cohen, C., Channen, L., Harty, A., Perumalswami, P., Dietrich, D., Schiano, T., Woodrell, C., & Agarwal, R. (2024). Outcomes of a 3-Year Quality Improvement Study to Improve Advance Care Planning in Patients With Decompensated Cirrhosis. American Journal of Gastroenterology, 119(3), 580-583. https://doi.org/10.14309/ajg.0000000000002570

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

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\%{\textendash}36\%) and earlier AD completion, particularly among those divorced, with alcohol-associated liver disease, and with higher Model of End-Stage Liver Disease{\textendash}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.",

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

year = "2024",

month = mar,

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doi = "10.14309/ajg.0000000000002570",

language = "English",

volume = "119",

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journal = "American Journal of Gastroenterology",

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Patel, A, Bowman, CA, Prause, N, Kilaru, SM, Nguyen, A, Kogekar, N, Cohen, C, Channen, L, Harty, A, Perumalswami, P, Dietrich, D, Schiano, T, Woodrell, C & Agarwal, R 2024, 'Outcomes of a 3-Year Quality Improvement Study to Improve Advance Care Planning in Patients With Decompensated Cirrhosis', American Journal of Gastroenterology, vol. 119, no. 3, pp. 580-583. https://doi.org/10.14309/ajg.0000000000002570

TY - JOUR

T1 - Outcomes of a 3-Year Quality Improvement Study to Improve Advance Care Planning in Patients With Decompensated Cirrhosis

AU - Patel, Arpan

AU - Bowman, Chip A.

AU - Prause, Nicole

AU - Kilaru, Saikiran M.

AU - Nguyen, Andrew

AU - Kogekar, Nina

AU - Cohen, Cynthia

AU - Channen, Lindsay

AU - Harty, Alyson

AU - Perumalswami, Ponni

AU - Dietrich, Douglas

AU - Schiano, Thomas

AU - Woodrell, Christopher

AU - Agarwal, Ritu

PY - 2024/3/1

Y1 - 2024/3/1

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/85187105723

U2 - 10.14309/ajg.0000000000002570

DO - 10.14309/ajg.0000000000002570

M3 - Article

C2 - 37934193

AN - SCOPUS:85187105723

SN - 0002-9270

VL - 119

SP - 580

EP - 583

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

IS - 3

ER -

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

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