{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T12:26:59Z","timestamp":1786796819493,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100030464","name":"Fan Fox & Leslie R. Samuels Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100030464","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100028004","name":"Healthcare Association of New York State","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100028004","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Advance care planning (ACP) aligns treatment pathways with patient preferences. Many acute care patients are admitted without advance care plans (AC-Plans) which may result in patients receiving care misaligned with their preferences. Accordingly, ACP is needed within hospitals, however, implementation barriers exist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate an ACP program developed by a 711-bed hospital to overcome many of the barriers to implementing hospital-based ACP. Success was measured as the percentage of patients with AC-Plans at discharge over the four-year study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The hospital\u2019s ACP program components included: primary palliative care, simulation-based training, and ACP and AC-Plan training and education. The sample consisted of patients aged 65 years and older who were admitted without documented AC-Plans, at the hospital, between November 1st 2021 to October 31st 2025. Primary evaluations consisted of examining yearly trends in the percentage of patients with AC-Plans at discharge with Kendall\u2019s tau and testing association between admission year and the likelihood of having an AC-Plan at discharge with a logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The sample consisted of 25,189 patients. The percentage of patients with ACPs at discharge increased from 4.4% to 19.1% from the first to fourth program year. The odds of having an AC-Plan at discharge in years 2, three, and four were 3.44 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), 5.87 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and 8.97 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) times higher than the odds of having one during the first program year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The growth and sustainability of the hospital\u2019s ACP program demonstrates that barriers to ACP within hospitals can be overcome and successful programs implemented.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091261476534","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T07:06:23Z","timestamp":1786518383000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Advance Care Planning in an Urban Hospital: Sustainability and Growth in Documenting Care Plans over Four-Years"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7152-968X","authenticated-orcid":false,"given":"Khadeja","family":"Kausar","sequence":"first","affiliation":[{"name":"Maimonides Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Coffield","sequence":"additional","affiliation":[{"name":"Hofstra University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sampath","family":"Gopalan","sequence":"additional","affiliation":[{"name":"Internal Medicine Resident, Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Tarkovsky","sequence":"additional","affiliation":[{"name":"Deptment of Medicine, Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Egan","sequence":"additional","affiliation":[{"name":"Hospice Physician, Calvary Hospice at Home, Calvary Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A","family":"Press","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinical Professor of Medicine, Division of Infectious Diseases, NYU Grossman School of Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Marshall","sequence":"additional","affiliation":[{"name":"Executive Vice President of Medical Affairs, Chief Medical Officer, Maimonides Medical Center, Brooklyn, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.12.331"},{"key":"e_1_3_7_3_2","unstructured":"Tangum C Benson WF. 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