The healthcare treatment Americans would choose near the end-of-life are often different from the treatment they receive.

Advance care planning is when people do what they can to ensure that healthcare treatment they receive is consistent with their wishes and preferences should they be unable to make their own decisions or speak for themselves. Unfortunately, there is a disconnect between care desired and care received which often leads to burdensome and potentially non-beneficial therapies that can increase suffering for patients and caregivers and contribute significantly to healthcare costs.

A compilation of studies from 2011-2016 shows the number of adults completing an advance directive has stayed static—only about one-third of adults have an advance directive expressing their wishes for end-of-life care.¹

The Great Plains QIN recently hosted a 90-minute webinar focusing on end-of-life care planning utilizing the Institute for Healthcare Improvement’s (IHI) framework for improving end-of-life care, which includes five “bite-sized” practical principles. A panel of local professionals provided strategies for increasing completion of advance directives for patients, staff and members of tribal communities.

Attendees were asked what one strategy shared could be implemented in their daily work. Responses ranged from “encourage my facility to provide more assistance with end-of-life care planning” to “advocate for my patients/residents and do my best to make sure their wishes are followed.” Many attendees were also interested in culturally-appropriate approaches to advance care planning.

All of the strategies shared can be accessed, via the webinar recording, as well as the presentation slides and advance care planning resources. Click here to visit the event page to access these resources.


  1. Kuldeep N. Yadav, Nicole B. Gabler, Elizabeth Cooney, Saida Kent, Jennifer Kim, Nicole Herbst, Adjoa Mante, Scott D. Halpern, and Katherine R. Courtright. Approximately One in Three US Adults Completes Any Type Of Advance Directive For End-Of-Life Care. Health Affairs. http://content.healthaffairs.org/ by Health Affairs; July 12, 2017.