Advance Care Planning: Teaching Discussions about End of Life Care

This project aims to bring Union College students into the Schenectady community to directly interact with patients in conversations about Advance Care Planning. As the result of New York State’s Delivery System Reform Incentive Payment (DSRIP) Program, healthcare providers have been trying to identify ways of providing better comprehensive care services to reduce Medicaid patients’ likelihood of unnecessary hospitalization. One indirect plan of care that could accomplish this is to increase the use of health care proxies and other advanced directives.  This presentation will describe a new initiative that set out to train students to provide advanced care discussions with patients in two different clinical settings.  College students were given instruction that prepared them to have 15-45-minute conversations with patients in the community.   From January-March 2018, conversations about end of life care occurred with over 40 patients from diverse backgrounds. This public health initiative has resulted in the creation of Health Care Proxies for over half of the patients with who conversations were initiated, with many others scheduling further appointments for more discussion on the difficult topic.