A New Vision for Advance Care Planning

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Normalizing advance care planning as a regular, expected part of medical care at UCLA Health is the vision of the UCLA Health Advance Care Planning Program.  Under the ACP program, launched in 2013, advance care planning is being implemented across the health system in a strategic fashion appropriate for each patient’s level of illness and readiness to participate.

The well-informed patient who can participate in shared decision-making to guide care that matches goals is a critical component of UCLA Health’s mission to provide world-class quaternary medical care and also high value, comprehensive care to the UCLA Health primary care population.  To accomplish this, UCLA Health is implementing programs and practices to routinely elicit patient preferences and to incorporate patients’ fully informed goals into treatment.  With support from the Coalition for Compassionate Care of California and a guiding stakeholder group, we are implementing a system wide program for advance care planning.

The UCLA Advance Care Planning Program includes:

  1. Standardized ACP Process - Patients approached iteratively at key points and venues, according to their illness level and other factors, to discuss goals, consider future health states and complete advance directives, as appropriate; “communication promoters” intensively trained to use tailored communication guides to implement strategic ACP appropriate for a patient’s level of illness and readiness;  and ACP preserved across transitions.
  2. ACP Materials - Tailored and branded advance care planning materials to inform patients and promote ACP available for use throughout the system.
  3. Training mechanism yielding individuals to reproducibly implement the standardized ACP process in a clinically astute fashion - Education programs to inform clinicians and trainees about ACP process and their role.
  4. CareConnect infrastructure for maintaining ACP preferences so they can be iteratively updated and applied at the point of care - Clinicians recording and building on ACP documentation in CareConnect infrastructure to inform care in real time
  5. Metrics to evaluate ACP interventions and drive QI - Metrics evaluate match of treatments with preferences and prognosis, level of ACP and utilization of resources to guide program quality improvement.