SHM Converge Scientific Abstract ePoster Gallery-Improving Mdpoa Rates

Pdf Summary

This project aimed to increase the rate of documented medical durable power of attorney (MDPOA) assignments for patients discharged from an oncology hospitalist service line. Having an MDPOA ensures that patient wishes are followed if they become unable to make medical decisions, and it reduces stress for families and staff during emergencies.<br /><br />To address a gap in advanced care planning, the hospital medicine division created a new transitions of care coordinator role. This non-clinical coordinator was trained by clinical directors and social workers on MDPOA laws, hospital requirements, standardized forms, and the use of normalized language when discussing proxy designation with patients. Example phrasing included explaining that everyone should have an MDPOA in case of emergency and asking patients whom they would trust to make decisions on their behalf.<br /><br />The workflow involved identifying patients without MDPOAs through a custom electronic health record list, confirming decision-making capacity with the primary team, discussing the process with the patient, completing the form, and uploading it into the electronic health record.<br /><br />Results showed substantial improvement. Before the intervention, from July 1, 2021 to June 30, 2022, 66.2% of 1,623 discharged patients had an MDPOA listed. After the pilot began on December 19, 2022, the rate increased to 91.8% among 1,055 discharged patients through June 30, 2023. During this period, the coordinator directly assisted 219 patients, or 21% of discharges, in completing MDPOA documentation.<br /><br />The project concluded that a dedicated, trained coordinator can effectively improve advanced care planning documentation in an oncology population and help normalize an important part of patient-centered care.

Asset Subtitle

Li-Kheng Ngov

Meta Tag

Author List Eric Grimm, Kasey Bowden, Li-Kheng Ngov, Mario Rubio

Category Innovations

Concept Legally Appointed Surrogate

Concept Decision-Making Capacity

Concept Transitions of Care Coordinator

Concept Screening

Distinguished Non-Finalist

Presenter Organization University of Colorado

Presenting Author Li-Kheng Ngov

Track Other

Keywords

medical durable power of attorney

MDPOA

advanced care planning

oncology hospitalist service

transitions of care coordinator

patient discharge

electronic health record

decision-making capacity

proxy designation

patient-centered care

Legally Appointed Surrogate

Decision-Making Capacity

Transitions of Care Coordinator

Screening