SHM Converge Scientific Abstract ePoster Gallery-Optimizing Discussion of Advance Directives and Completion of Molst Forms in Community-Based Hospital in Brooklyn, Ny

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This performance improvement project at Wyckoff Hospital’s 9 South telemetry/stroke unit aimed to increase completion of MOLST forms by improving discussions of advance directives during hospitalization. MOLST forms are New York State medical orders that document patient preferences for life-sustaining treatment, including DNR and DNI decisions, and help ensure those wishes are honored across care settings.<br /><br />The intervention focused on educating residents, nurses, social workers, and case managers about the importance of advance directives and how to complete MOLST forms. A virtual noon conference led by a palliative care physician trained residents to start these conversations and complete the form. The topic was also reinforced during rounds and staff meetings.<br /><br />The team compared MOLST completion rates before the intervention (October–December 2020) with rates after the intervention (January–May 2021). Before the intervention, 740 patients were discharged; 20 forms were completed during admission, and 65 patients had a MOLST form at discharge. After the intervention, 1,397 patients were discharged; 40 forms were completed during admission, and 83 patients had a MOLST form at discharge. This represented a major increase in monthly MOLST completions by staff, from about 7 to 40 per month, and a significant rise in total MOLST forms at discharge. The improvements were statistically significant.<br /><br />The authors conclude that educating healthcare staff and raising awareness about advance directives can substantially improve MOLST completion in the inpatient setting. They recommend continuing regular monitoring, reinforcing education over time, involving families in discussions, and expanding the project to other hospital units.

Asset Subtitle

Juan Carlos Fuentes-Rosales

Meta Tag

Author List Juan Carlos Fuentes-Rosales, Louis Martinucci

Category Research

Concept MOLST Form

Concept Advance Directive

Concept Life-Sustaining Treatment

Concept Advance care planning

Concept Completion Rate

Distinguished Non-Finalist

Presenter Organization Wyckoff Heights Medical Center

Presenting Author Juan Carlos Fuentes-Rosales

Track Quality Improvement

Keywords

MOLST forms

advance directives

telemetry unit

stroke unit

palliative care

DNR

DNI

hospitalization

staff education

quality improvement

MOLST Form

Advance Directive

Life-Sustaining Treatment

Advance care planning

Completion Rate