Advance Care Planning Provider Education: Solution to Improve Provider Self-Efficacy

Healthcare providers are not comfortable having Advance Care Planning (ACP) conversations with patients and families. This project aimed to determine if ACP education modules improve self-efficacy with ACP. The project was a pre-/post-implementation design utilizing the validated ACP Self-Efficacy (ACP-SE) survey. Participants completed the pre-test ACP-SE followed by four Center to Advance Palliative Care (CPAC) ACP education modules and a Project-Lead-developed state-specific advance directive (AD) module that were accessed on-demand electronically. Participants were Advanced Practice Providers (APPs; n=21) on the inpatient heart failure service at an urban academic medical center. Thirteen APPs had complete pre and post-test and surveys data (61.9%). The majority of participants were white (95%), female (92%), aged 20-39 (83%), and NPs (62%) with 0-5 years of experience. The Wilcoxon Signed Rank Sum Test was used for median sum ACP-SE score comparisons for paired pre/post data. There was a significant median increase in ACP-SE scores pre and post intervention (W=2.9; p=0.002). The number of ACP conversations post-education modules ranged from 0-11 with a mean of 3.2 per APP, and a total of 68 conversations for all APPs during the month after the intervention. With increasing comfort and self-efficacy for discussing ACP, the desired effect is that ACP discussions will become a routine component of patient care