The Apex interface to find information on advance directives and POLST forms is very basic and deficient when searching for surrogate decision makers. In several instances the information is inaccurate or incomplete, leaving providers in the very difficult position of trying to implement the best interventions for each patient. This effort usually requires a substantial investment of time and resources in the attempt to clarify important directives with the patients or to search for decision makers. The aim of this proposal is to improve the accuracy of the current Apex interface and to create a new one to find surrogate decision makers. Such goals requires several steps: 1) Education of health care providers to conduct timely and adequate conversations with patients and families; 2) Streamlining the process of obtaining and entering advance directives and POLST forms in Apex; 3) Create in Apex an efficient search system for surrogate decision makers’ name and contact information. This will be the scholarly and QI project focus within the Social Work Fellowship in Palliative Care. A social worker will be hired for advanced interdisciplinary training in Palliative Care and will assess and address the systemic issues related to documentation regarding surrogate decision makers and advance directives, enhancing the health care team’s ability to negotiate complex medical decision making with patients and families. He/she will closely work with different health care providers, including faculty, residents, fellows, nurses, unit clerks and IT analysts.
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