Advance Care Planning

What Is Advance Care Planning (ACP)?

Advance care planning is the process by which people think about their preferences for medical care, discuss them with family and healthcare providers, and document them so that their wishes are clear and available in case of medical crisis or need. (Tip: This process is completed "in advance" of that crisis or need, hence "advance" (not advanced) care planning!)

The Need for ACP

In the current healthcare world, there can be substantial misalignment between the medical care people want during serious illness and the medical care they actually receive. Unfortunately, people are often not encouraged or equipped to speak up for the kind of care they want, and clinicians are often not trained to talk with patients about their treatment options and preferences. When such a discussion does happen, the process sometimes consists of checkbox forms and jargon-laden hypotheticals, rather than meaningful conversations about preferences, values, and goals over time. Short-circuited conversations can too easily lead to aggressive, nonbeneficial care, which in many instances is not in line with a patient’s best interests or values.

Identified by the American Academy of Physicians as one of the top high-quality, low-cost interventions for healthcare systems and providers for increasing patient satisfaction, advance care planning can lead to:

  • Improved patient and family satisfaction
  • More efficient allocation of resources
  • Reduced readmissions
  • Improved facilitation of skilled nursing facility transfers
  • Reduced provider stress
  • Proper use of POLST

How CCCC Can Help

The Coalition for Compassionate Care of California (CCCC) provides many tools and resources to help providers have more meaningful conversations about their patients' preferences, values, and goals for their medical care.

ACP Innovation Award to Providence Institute for Human Caring

Despite decades of promotion by healthcare providers, advance care planning is used by only about a quarter of the public and has been the subject of recent criticism in the healthcare community. The ACP Innovation Award was launched in 2024 to recognize advance care planning programs, tools, processes, or frameworks that are Amazing Creative Profound or Actionable Clever Practical or Authoritative Comprehensive Persuasive.

Ten submissions were received from a wide variety of settings proposing a wide variety of solutions. The Providence Institute for Human Caring’s Trusted Decision Maker program was selected by a distinguished panel of judges as the entry that met the most criteria. 

“I love the simplicity of this intervention (e.g., using TurboTax as a source of inspiration, etc.),” said one judge, “as that simplicity bodes well for [the intervention’s] stability and generalizability. It also, in my humble view, speaks volumes about the innovators who aren't trying to ‘redesign advance care planning’ using sophisticated new technology, but based on existing tools and their understanding of where people are.”

Read Providence Institute for Human Caring’s submission, Back to Basics: Simplifying Advance Care Planning here.

Submissions for the award were evaluated by a distinguished panel of judges:

  • Aretha Delight Davis, JD, MD, co-Founder of the ACP Decisions Foundation and CEO of ACP Decisions.
  • Ronit Elk, PhD, professor in the Center for Palliative and Supportive Care, Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of Alabama, Birmingham.
  • Marian Grant, DNP, ACNP-BC, ACHPN, FPCN, FAAN, RN, a policy consultant for the Coalition to Transform Advanced Care (C-TAC), the Center to Advance Palliative Care (CAPC), and the National Patient Advocacy Foundation, and a marketing consultant for the University of Washington’s MessageLab Serious Illness Messaging project, and VitalTalk.
  • Joe Rotella, MD, MBA, HMDC, FAAHPM, chief medical officer of the American Academy of Hospice and Palliative Medicine (AAHPM).

To submit your program or idea for the 2025 ACP Innovation Award, download the submission guidelines here. Deadline for submissions is March 3, 2025.

ACP Conversation Training

Advance care planning programs require training, materials, and resources to teach, guide, and document conversations about advance care planning and goals of care. ACP Client Services provides expert-level training in either direct-to-staff or train-the-trainer format. Following training, your clinicians will be able to provide high-quality advance care planning. Having trainers within your organization will make your program self-sustaining.

If advance care planning training is already operational in your organization, our team can help you evaluate your current processes and refine and improve your training with fresh tools and new curriculum.

Learn More: Contact us and learn more about how ACP Client Services can help your organization and your patients.

ACP Tools and Resources

Sudden changes in your life, such as being involved in an accident or becoming seriously ill, can be hard to prepare for. There are ways to consider, express, and document the type of care and medical treatment you want in such a crisis, before it happens. CCCC has the tools and resources to meet your needs. Our materials are ready to use, vetted for literacy levels, and have been demonstrated to be effective. We also offer a variety of translation options.

The Coalition for Compassionate Care of California (CCCC) encourages you to talk to your loved ones now about your wishes for medical care and treatment in the event that you are unable to speak for yourself. Planning ahead for future medical needs allows for the best chance that your wishes will be respected.

Learn More: If you’re not sure how to have these difficult conversations, don’t know where to begin or what form to use, we have resources that can assist you.