Advanced Care Planning Discussions and Documentation in Primary Care
- UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
- Tanya Litchmore-Porter (Creator)
- Institution
- The University of North Carolina at Greensboro (UNCG )
- Web Site: http://library.uncg.edu/
- Advisor
- Cheryl Wicker
Abstract: Background: As the life spans of Americans are increasing, so is the number of people who are living longer with multiple chronic comorbid conditions. Advanced care planning is, therefore, important because it is a process that helps patients discuss and communicate their future treatment and end-of-life preferences with their providers if they lose their capacity to make decisions or communicate their wishes and preferences. Primary care settings are ideal for integrating advanced care planning into routine care and health maintenance. Purpose: This project aims to increase advanced care planning discussions and documentation in a primary care clinic through a workflow that identifies patients without advance directives and educates staff and providers about appropriately documenting and billing for advanced care planning discussions. Methods: Under the framework of the Transtheoretical Model, this quality improvement project implemented different interventions to increase advanced care planning discussion rates. A live PowerPoint presentation was conducted with the clinic staff on appropriately identifying patients without advance directives documents. Additionally, information was provided on how to document and bill advanced care planning discussions. Advanced care planning current procedural terminology code billing frequencies were tracked pre and post intervention over three months. Results: Descriptive statistics was used to analyze the data because it was small; this also meant there would be no hypothesis testing. Four providers participated, and the project resulted in a slight increase in advanced care planning billing codes post intervention compared to pre intervention. The pre intervention phase revealed 3 documented advanced care planning billing codes 99497. There was no documentation for billing code 99498. The post intervention phase had 5 documented billing codes, including 99497. Recommendations and Conclusion: The project identified that timing can be a barrier for providers in primary care clinics. As a result, this can affect the number of advanced care planning discussions and documentation conducted. A standardized system, such as utilizing support staff to engage in the advanced care planning process, can help increase those rates. Advanced care planning can increase revenue for primary care settings and the overall quality of care rendered during end-of-life.
Advanced Care Planning Discussions and Documentation in Primary Care
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Created on 6/27/2024
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Additional Information
- Publication
- Other
- Language: English
- Date: 2024
- Keywords
- advance care planning, advance directives, primary care, end-of-life care