Advance Care Planning One-Page Keystone Document: A Product of a Palliative Care Advisory Council
Thursday, October 12, 2023
9:45 AM – 11:00 AM ET
Location: Heron (Fourth Floor)
Common patient- and public-facing advance care planning (ACP) formats are long, some between 12 and 20 pages, and have divergent foci, for instance from having difficult conversations to thinking about specific medical interventions. Literature has reservations about the helpfulness of advance directive documents and ACP mechanisms, while also advocating the helpfulness of new ideas, such as using life goals (a "bucket list") with documents and mechanisms. Yet current formats and mechanisms have been slow to adopt new ideas, which does not provide help for clinical providers, for example, presented with patients' unrealistic life goals and "bucket lists." Patients and the public have confusion about integrating one ACP format, much less weaving different mechanisms into an integrated whole.
A palliative care advisory council went through a structured exercise to identify strengths and weaknesses of several ACP formats. Group members felt the best way to minimize overwhelmed patients and public was to create a keystone document to serve as a referral to other resources. The one-page keystone document resulted, which pinpoints where each person is in an ACP process, weaves together different mechanisms into an integrated whole, and uses QR codes to connect with appropriate resources to help.