A scalable multidisciplinary education model to improve advance care planning readiness across a large outpatient oncology network.

Abstract

269 Background: Advance care planning (ACP) is a critical strategy to support goal-concordant care and improve end-of-life (EOL) quality outcomes; however, variability in clinician preparedness limits consistent integration into practice. We developed a system-wide education initiative focused on increasing staff and provider knowledge, confidence, and engagement with advance directives (ADs), including encouragement to complete their own medical power of attorney and directive to physicians and family documentation. Methods: A multidisciplinary task force developed a standardized ACP education model and toolkit for dissemination across approximately 280 oncology practice sites. Local leaders were asked to host staff and provider ACP events using centralized materials. Social workers, advanced practice providers, and nurse managers served as site champions. A pre/post survey design assessed familiarity with accessing and completing state-specific AD forms and confidence in engaging in ACP discussions. Pre-event (n=390) and post-event (n=96) responses were collected. Results: Familiarity with accessing and completing AD forms increased by 52% from pre- to post-intervention. Confidence improved substantially, with 92 of 96 respondents (96%) reporting high or highest confidence (4–5/5), including 78 (81%) at 5/5. These findings demonstrate improvements in both knowledge and perceived self-efficacy among participants completing post-event assessment. Conclusions: A standardized, scalable ACP education initiative implemented across a large outpatient oncology network improved staff readiness to support advance care planning. This model leverages multidisciplinary leadership and structured resources to drive practice change at scale. Encouraging staff engagement with advance directives, including personal completion, may further enhance readiness and support more confident, role-appropriate ACP conversations with patients, potentially improving patient understanding of ACP and supporting increased completion and documentation. Future work will evaluate whether increased preparedness translates into higher rates of ACP conversations, documentation, and improved EOL quality metrics. This approach may serve as a replicable framework for health systems seeking to strengthen ACP integration into routine oncology care.