Date of Award
Spring 5-2026
Document Type
DNP Project
Project Team Faculty Member
Laurie Hopper
Project Team Faculty Member
Kate Traum
Keywords
Advance Care Planning, primary care, cultural competence, patient engagement, quality improvement
Abstract
This quality improvement project evaluated a structured ACP intervention in a small yet fast- paced, urban primary and urgent care clinic serving a predominantly African American population in Chicago. Guided by the CARES framework, the project aimed to improve provider confidence, cultural competence, and patient engagement. All clinical and supportive staff within the clinic (2 physicians, 1 physician assistant, 1 nurse practitioner, 2 registered nurses, 1 medical assistant, 1–2 rotating medical/APRN students) completed a five-week training program on ACP principles, culturally sensitive communication strategies, and optimized electronic medical record (EMR) workflows, including templates, eligibility flags, and reminders. Eligible patients were aged 65 or older or had dementia, terminal illness, or chronic life-limiting conditions. Data were collected two months before and after the intervention. Likert scale surveys revealed that provider confidence in initiating ACP increased from moderate to high, while cultural competence ratings improved by one level across staff. Patient responses shifted from neutral to agree or strongly agree regarding ACP clarity, usefulness, and trust in providers. Additionally, there were increases in documented ACP discussions, increases in ACP specific CPT code usage, and increases in educational material distribution. Findings suggest that combining structured training, EMR optimization, and culturally responsive care can substantially enhance ACP delivery and patient–provider communication in primary care settings, offering a replicable model for diverse communities.
Recommended Citation
Young, Dajauna, "ACP in primary care setting" (2026). Doctor of Nursing Practice Projects. 355.
https://spark.siue.edu/dnpprojects/355
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