“How do you want to live until you die?”: Scaling Compassionate Advance Care Planning Conversations Across a Health System

INTEGRIS Health, Oklahoma’s largest not-for-profit health system, started the region’s first advance care planning (ACP) program in 2021 to make sure it was consistently facilitating and recording ACP discussions with patients in its hospitals and clinics. At the root of the program was one essential goal: making sure that patients receive the care they want to receive, even if they lose the ability to speak for themselves. With the program in place, the percentage of hospitalized patients with a code status on file rose from 90% to more than 99% at the flagship hospital, INTEGRIS Health Baptist Medical Center, and the percentage of patients 65 and older who have ACP documents on file climbed from less than 30% to 50%.

How They Did It:

• Built a code status advisory to prompt clinicians to enter accurate code statuses
• Conducted targeted ACP conversations with patients in both the hospital and the clinic
• Implemented an ACP navigator for clinicians to record patients’ wishes in their own words

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