Advance Directives in the Primary Care Setting

Title & description

Advance Directive – the Primary Care Physicians’ Perspective and Key Role for Patients 65 years and older

This project is part of a statewide effort among members of the Wisconsin Geriatric Education Center (WGEC) and 3 of its Partners: Aurora Health Care, Medical College of Wisconsin, and the University of Wisconsin – School of Medicine and Public Health.

The project is supported in part by a HRSA Geriatrics Workforce Enhancement Program award to WGEC – Marquette University with a Subcontract to the Medical College of Wisconsin [HRSA Grant # U1QHP28712].

Why Should a Primary Care Physician/Provider (PCP) Take Time to Address Advance Directives?  

  • It demonstrates that you honor and respect your patients and their preferences.
  • 89% of patients and families want their primary care providers to have these conversations per recent studies.
  • 89% of PCPs agree that it is important that health care providers have Advance Directive conversations with patients – 48% reporting that it is extremely important.
  • 75% of PCPs report it is their responsibility to initiate Advance Care planning for Medicare patients.

PURPOSE: Improve geriatric care by improving the PCP’s ability to initiate brief and impactful AD discussions with patients 65 years and older.  This is the first step towards increasing the percentage of your patients (or your clinic’s/group’s patients) 65 years and older who have an Advance Directive with minimal time spent. 

HOW:   Using a two-cycle PDSA approach – we will prepare you to initiate brief, yet impactful, conversations with your patients 65 years and older about the importance of completing an Advance Directive.  We will emphasize the PCP’s role in brief interactions with his/her patients that can positively impact Advance Directive completion. 

SPECIFIC GOAL:  Improve geriatric care by improving the PCP’s ability to initiate brief and impactful Advance Directives discussions with patients 65 years and older.


  1. To identify barriers and biases related to initiating Advance Directive discussions in the primary care setting
  2. To explain the importance of Primary Care Provider involvement in Advance Directive discussions addressing barriers/biases 
  3. To initiate Advance Directive discussions with geriatric patients in the primary care setting 

Maintenance of Certification (MOC) Part IV - ABMS 

An "active participation role" means the practitioner must:

•    Provide direct or consultative care to patients as part of the QI project.
•    Implement the project’s interventions (the changes designed to improve care) and reflect on the tools you selected to see if they are the correct tools to make a change.
•    Collect, submit and review data in keeping with the project’s measurement plan with two linked cycles of data review.
•    Collaborate by actively discussing what you have learned with at least two people.

ACCME Accreditation Statement:
The Medical College of Wisconsin is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

AMA Credit Designation Statement:
The Medical College of Wisconsin designates this PI- CME for a maximum of 20  AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Time & place
Start and expiration dates: 
Friday, July 1, 2016 - Sunday, December 31, 2017
Please log in or register to take this Activity set.
CME Coordinator Contact Information
Judy Myers
Phone Number:: 
+1 (414) 955-5658