Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)
Poster Number
25h
Document Type
Poster
Status
Recent Alumni
Abstract Category
Health Policy and Management
Keywords
Advance Care Planning, Medicare Reimbursement, End-of-life, Patient/Physician/Political Barriers, Aging
Streaming Media
Publication Date
Spring 2018
Abstract
Objectives: Current barriers to implementing Advanced Care Planning (ACP) will be examined as applied to the healthcare system.
Methods: A literature review was performed looking at the current practices of ACP (e.g. filling out advanced directives (AD), Medical Orders for Life Sustaining Treatment (MOLST)/ Physician Orders for Life Sustaining Treatment (POLST), etc.), physician comfort level with having end-of-life discussion (EOL), successful/unsuccessful interventions to increase ACP/EOL discussions among health care providers (HCP), and the current political environment with respect to physicians’ ability to implement ACP/EOL discussions. Cochrane, Pubmed, and Google Scholar were searched for papers written in English after 2000 in the United States In order to be eligible, the studies were required to discuss educational interventions, patient/physician barriers, and/or political barriers surround ACP/EOL discussions.
Results: Seventeen articles were identified to meet the inclusion criteria and are included in this review. Barriers identified by both the physician and the patient were: lack of time, lack of awareness, lack of comfort, and lack of a systematic approach. Educational interventions for health care providers somewhat improved comfort levels. The introduction of the Medicare Reimbursement had a substantial impact on increasing the amount of ACP/EOL conversations reported.
Conclusions: Although there is some evidence that educational interventions aimed at health care providers improves the providers’ knowledge, self-efficacy, and communication with regards to ACP, health-system and political barriers remain to impact ACP implementation. Medicare reimbursement not only allows physicians to be paid for their time facilitating these discussion, but legitimizes its need. It is recommended that a systematic approach to ACP, throughout the course of the patient’s life, will improve implementation rates and physician/patient comfort levels with ACP/EOL discussions.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Open Access
1
Included in
Counseling Commons, Geriatrics Commons, Health Policy Commons
(VIDEO) Barriers to Implementing Advance Care Planning in the Healthcare Setting
Objectives: Current barriers to implementing Advanced Care Planning (ACP) will be examined as applied to the healthcare system.
Methods: A literature review was performed looking at the current practices of ACP (e.g. filling out advanced directives (AD), Medical Orders for Life Sustaining Treatment (MOLST)/ Physician Orders for Life Sustaining Treatment (POLST), etc.), physician comfort level with having end-of-life discussion (EOL), successful/unsuccessful interventions to increase ACP/EOL discussions among health care providers (HCP), and the current political environment with respect to physicians’ ability to implement ACP/EOL discussions. Cochrane, Pubmed, and Google Scholar were searched for papers written in English after 2000 in the United States In order to be eligible, the studies were required to discuss educational interventions, patient/physician barriers, and/or political barriers surround ACP/EOL discussions.
Results: Seventeen articles were identified to meet the inclusion criteria and are included in this review. Barriers identified by both the physician and the patient were: lack of time, lack of awareness, lack of comfort, and lack of a systematic approach. Educational interventions for health care providers somewhat improved comfort levels. The introduction of the Medicare Reimbursement had a substantial impact on increasing the amount of ACP/EOL conversations reported.
Conclusions: Although there is some evidence that educational interventions aimed at health care providers improves the providers’ knowledge, self-efficacy, and communication with regards to ACP, health-system and political barriers remain to impact ACP implementation. Medicare reimbursement not only allows physicians to be paid for their time facilitating these discussion, but legitimizes its need. It is recommended that a systematic approach to ACP, throughout the course of the patient’s life, will improve implementation rates and physician/patient comfort levels with ACP/EOL discussions.