Advance Care Planning (ACP) Discussion Guide And Visit Documentation Template
Publication Date: January 2, 2018
5-S (Environment)
5-S (Environment)
- Scene – Select location for privacy and comfort sensitive to patient’s needs.
- Setting – Create friendly, engaging, quiet and confidential environment.
- Seating – Make patient, family, staff at ease; seating that is congenial and conducive to interaction.
- Scenario – Long-Term Care (LTC) and other settings.
- Start with open ended question – No interruption for the first two minutes and allow silence between responses.
C-A-R-E (Engagement)
...C-A-R-E (...
...D CLARIFY Cause: What is the r...
P-L-A-N (Execution)
...P-L-A-N (Execut...
...PLAN Prepare: Document the Advance Care...
ACP Visit Documentation Template
...cumentation TemplateACP Template Sample...