Understanding Best Practices in Advance Care Planning

Barnato is the Susan J. and Richard M. Levy Distinguished Professor in Health Care Delivery at the Geisel School of Medicine and a palliative care doctor at Dartmouth-Hitchcock Medical Center. Photo by Mark Washburn.

Advance care planning (ACP) conversations between physicians and older adults are associated with care that aligns patient goals with the treatment they receive. Yet only a small percentage of acute care providers in hospital settings are engaging in these discussions. The low rates underscore the need for quality-improvement interventions to increase physician participation in ACP.

In order to improve care for seriously ill, older adults in a hospital setting, researchers from The Dartmouth Institute for Health Policy and Clinical Practice, led by Amber Barnato, MD, MPH, have partnered with a national physician management group to better understand best practices in ACP. The project aims to: understand the decision-making process influencing the likelihood of hospital-based physicians having ACP discussions with the seriously ill; explore the association between acute care ACP and patient care outcomes; and test the effect of interventions designed to promote ACP discussions using a randomized trial.