The following is a summary of “Evolving Advance Care Planning in a Health Ecosystem: The Kaiser Permanente Experience,” published in the August 2023 issue of Pain and Symptom Management by Ngo et al.
Advance care planning is crucial in providing comprehensive care to individuals experiencing severe illness and near the end of their lives. Several medical advance care planning components may need more adaptability in accommodating patients’ fluctuating disease conditions and evolving objectives as their serious illness advances. Medical institutions are beginning to establish protocols to tackle these obstacles, although the execution has shown variation.
In 2017, Kaiser Permanente implemented Life Care Planning (LCP), integrating advanced care planning seamlessly with concurrent disease management. The LCP (Lung Cancer Protocol) offers a structure for identifying substitute decision-makers, documenting objectives, and eliciting patient preferences throughout the illness. LCP offers standardized training to enhance communication and employs a centralized section within the electronic health record for longitudinal documentation of objectives.
Over 6,000 healthcare professionals, including physicians, nurses, and social workers, have received training in the LCP (Life Care Planning) program. Over one million patients have participated in LCP (Lifespan Care Program) since its establishment, with over 52% of patients aged 55 and above having a surrogate assigned. There is substantial evidence of elevated treatment concordance with patients’ desired wishes (88.9%) and notable completion rates of advance directives (84.1%).