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Am J Hosp Palliat Care. 2019 Feb;36(2):143-146. doi: 10.1177/1049909118797612. Epub 2018 Aug 28.

Advance Care Planning in Community: An Evaluation of a Pilot 2-Session, Nurse-Led Workshop.

Author information

1 Division of Palliative Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
2 Georgetown University School of Medicine, Washington, DC, USA.
3 Jewish Family and Children's Services, San Francisco, CA, USA.
4 Division of Hematology and Oncology, Department of Medicine, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA, USA.



Engaging patients in advance care planning (ACP) is challenging but crucial to improving the quality of end-of-life care. Group visits and multiple patient-clinician interactions may promote advance directive (AD) completion.


Facilitate ACP discussions with patients and caregivers and the creation of notarized AD's at a comprehensive cancer center.


Two-session, nurse-led ACP workshops for patients and their family caregivers.


The workshop was offered to patients with cancer at a comprehensive cancer center and their family caregivers.


Validated 4-question ACP engagement survey, creation of a notarized AD by end of the workshop, and semistructured interviews.


Thirty-five patients participated in 10 workshops held March 2017 to February 2018. Median age was 52. Of 35, 24 (68.5%) patients completed pre- and postworkshop evaluation surveys. Mean preworkshop ACP readiness was 3.64 of 5; postworkshop readiness increased to 4.26 of 5 ( P = .001). Of 26, 17 (65.4%) of the patients who attended both workshop sessions had a new notarized AD scanned into the electronic medical record at the completion of the workshop series. Three family caregivers completed and had their own ADs notarized. Patient and family member response was overwhelmingly positive, with participants citing opportunities for group discussion and inclusion of family caregivers as important.


The ACP workshop was well received by participants and increased ACP readiness, discussion, and completion. Attendance at the workshop was low and barriers to attending workshops must be explored.


advance care planning; advance directive; cancer center; durable power of attorney for health care; family caregivers; notorization

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