Does Focused Advanced Directive (AD) Education Improve Provider Competency and Increase Completion Rates?

Abstract

Purpose: This study assesses the baseline knowledge of Advanced Directives (AD) within the Vanderbilt Hospital-At-Home (VHaH) unit, performs online education, and reassesses the knowledge post-education as well as analyzes the impact on AD post-education. Methods: Using a Plan-Do-Study-Act (PDSA) process framework; scholarly literature, internal data, and a focus group session informed the specific problem, which supported educational content development. A RedCap survey instrument was distributed to obtain project data, which was analyzed to compare the knowledge base pre and post-education intervention. Internal unit analytics will also monitor AD completion rates to compare rates pre and post-educational intervention. Results: N=10 (55%) VHaH team members completed the post-education survey compared to 100% completing the pre-education survey. 100% of respondents found the module valuable and that ADs are necessary. 90% felt that AD was a part of their daily activities compared to 72.2% from pre. 90% felt that the educational module increased their understanding of ADs. 90% felt that after the educational module, they could have a comprehensive discussion with their patients about AD compared to 66.7% pre. Following the training, respondents feel that they can initiate AD conversation for all of their patients who do not have an AD in their chart 40% stated they have enough time (16.7% pre) 70% felt confident with AD components (38.9% pre) Following the training 70% stated they were aware of the AD policy within VUMC (55.6% pre) Following the training, 50% of respondents stated that they have received the needed training on AD. Implications for Practice: AD helps medical doctors and clinical staff guide care for their patients. Focused continuing education on ADs increases the knowledge and awareness of the importance of them. Providers and clinical staff would benefit from annual education on AD and processes/resources within VUMC.