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- All Subjects: Advance Care Planning
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Disease burden is higher in the United States than in comparable countries. The Patient Self Determination Act of 1990 requires healthcare facilities to provide Advance Care Planning (ACP) information to all Medicare patients. The healthcare staffs’ (n=7) commitment to 3-days of ACP training increase ACP rates in the primary care setting. The Medicare Incentive Program is the platform for this initiative. This quantitative project used a valid and reliable pre and posttest design that consisted of 27 items on a Likert-scale. A 3.5-month chart audit (n=91) was conducted to assess the completion rate. Descriptive statistics was used to describe the demographic data.
The results of the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -2.37, p = .018. There was a significant increase in the post-readiness to change average scores. A Mann Whitney test was used to analyze the statistically significant difference between the averages in two ACP types and electronic health record documentation (EHR). Staff did not always code (Mdn = 0.00) but they documented in the EHR (Mdn =1.00; 512.00, p = 0.003). ACP discussion was performed 63% of the time during Annual Wellness Visits (AWV), and there was a 49% increase in the EHR documentation. Trained staff are key stakeholders in guiding ACP conversations. They understand the barriers, impact, and consequences related to the lack of advance directives.
Edition includes a gift inscription from author Clark E. Carr, "Presented to my friend Hon. WB. Brinton with my sincere regards. Clark Elarr. Christmas 1905."
This edition includes a gift inscription possibly penned by the author, Madison Julius Cawein, "Frank on Valentines Day, 1914. M.J." Madison Julius Cawein (1865-1914).
This edition includes an author's inscription written in two different pen colors, "J. W. Crawford aft Jack to Rev. W. O. Cornman."
Edition includes author's gift inscription, "From Fannie".
This edition has a gift inscription by author John Jay Chapman, "Miss Goodale from John Jay Chapman Merry Xmas 1914."
This edition includes a gift inscription by author Rev. J.A. Davis, "To Rev. A. G. Russell with the warmest regards of the author J.A. Davis."
This edition includes an author's inscription, "Very true and faithful Alice Brown. June 25, 1916."
This edition includes author Katharine Lee Bates' gift inscription, "This grave work is presented, at request, to Mildred C. Smith, president of the Wellerby Graduate Club, with Christmas Love from K.L.B. 1916."