Inpatient ACP Documentation
Prior to implementation of the videos, the rate of ACP completion for patients with late-stage disease was 3.2%. In the 21 months after the intervention, there was an increase in ACP documentation to 39.9%.
ACP documentation included completion of an advance directive, designating a durable power of attorney, a Physician Orders for Life-Sustaining Treatment (POLST) form, or any documentation of the patient's ACP preferences in the medical record. The primary document completed was a POLST form.
Ambulatory ACP Documentation
Primary care providers in Hilo had an ACP completion rate for this cohort of 37% compared to all other providers in the state, who had an average of 25.6%. (P < 0.001).
Hospital Referrals to Hospice
Prior to implementation of the videos, the rate of discharge to hospice for hospitalized patients with late-stage disease was 5.7%. After the intervention, there was an increase of late-stage patients discharged to hospice to 13.8%.
Average per patient savings for the last month of life in Hilo, Hawaii