Improving Presence of Advanced Directives in High-Risk Thoracic Oncology Patients

Throughout my career, Advance Directives have proven helpful by increasing the likelihood that patient wishes are followed as they approach end of life. Foundational to the completion of these documents is assurance that patient, caregiver, and medical provider are on the same page regarding prognosis, otherwise known as prognostic concordance. Without prognostic concordance, patients often believe they have a chance to be cured and will make decisions for more invasive care which is often non-beneficial, decreases quality of life, and increases the likelihood caregivers suffer depression after death.

This project endeavors to identify patients at high risk for mortality within the next 90 days, assess whether prognostic concordance exists, and schedule a family meeting if prognostic discordance is identified. The family meeting is an opportunity to ensure all are on the same page and if successful, will lead to an opportunity to complete advance directives in accordance with patient goals and values informed by accurate information.