ENgaging in Advance Care Planning Talks Group Visit Intervention

Change in Advance Directive in Medical Record

Any advance directive is present in the medical chart

Time frame: 0, 3, 6, 12 months

Change in Readiness to Engage in ACP (ACP Engagement Score)

The Advance Care Planning (ACP) Engagement Scale will be used to assess readiness to engage in specific parts of the advance care planning process (i.e. signing official papers to name a medical decision maker; talking to the decision maker; talking to the doctor; signing official papers putting their wishes in writing). Items are rated on a Likert scale, with possible scores ranging from 1-5. Higher scores indicate a higher level of engagement with the advance care planning behavior and a better outcome.

Time frame: 0, 6 months

Change in Readiness to Chose a Surrogate Decision Maker

Patient response to the question "How ready are you to sign official papers naming a medical decision maker to make medical decisions for you?". Responses were rated on a Likert scale, with possible scores ranging from 1-5. Higher scores indicate more readiness and a better outcome.

Time frame: 0, 6 months

Change in Readiness to Discuss Values and Care Preferences With Surrogate Decision Maker

Patient response to the question "How ready are you to talk with your decision maker about what kind of medical care you would want if you were very sick or near the end of life?". Responses were rated on a Likert scale, with possible scores ranging from 1-5. Higher scores indicate more readiness and a better outcome."

Time frame: 0, 6 months

Readiness to Talk to Patient's Physician About Future Medical Care

Patient response to the question "How ready are you to talk to your doctor about the kind of medical care you would want if you were very sick or near the end of life?". Responses were rated on a Likert scale, with possible scores ranging from 1-5. Higher scores indicate more readiness and a better outcome.

Time frame: 0 and 6 months

Readiness to Sign Official Papers About Medical Care

Patient response to the question "How ready are you to sign official papers putting your wishes in writing about the kind of medical care you would want if you were very sick or near the end of life?". Responses were rated on a Likert scale, with possible scores ranging from 1-5. Higher scores indicate more readiness and a better outcome.

Time frame: 0 and 6 months