Purpose
To establish standardized procedures for obtaining, documenting, and maintaining advanced directives in a concierge medical practice setting, ensuring compliance with state laws and optimal patient care.
Policy Components
1. Initial Documentation
- Request advanced directives documentation during patient enrollment
- Scan documents into EMR within 24 hours of receipt
- Flag patient charts with advanced directive status
2. Required Documents
- Living Will
- Healthcare Power of Attorney
- Do Not Resuscitate (DNR) orders, if applicable
- POLST/MOLST forms, where state-mandated
3. Annual Review Process
- Schedule annual review during comprehensive physical
- Document confirmation or updates in EMR
- Obtain updated copies if changes made
4. Staff Responsibilities
Medical Director
- Oversee policy implementation
- Review complex cases
- Ensure legal compliance
Practice Manager
- Maintain document filing system
- Coordinate staff training
- Audit compliance quarterly
Clinical Staff
- Verify documentation during visits
- Facilitate updates as needed
- Document all discussions
5. Emergency Protocols
- Maintain readily accessible copies
- Include advanced directive status in emergency packets
- Document adherence to directives
Documentation Requirements
-
Patient File Must Include:
- Signed copies of all directives
- Annual review documentation
- Communication logs
- Updates/modifications history
-
EMR Documentation:
- Prominent advanced directive indicator
- Scanned copies of current documents
- Review dates and outcomes
Legal Considerations
- Comply with state-specific requirements
- Maintain attorney-reviewed forms
- Document all patient education efforts
Review and Updates
- Annual policy review required
- Update as needed for legal compliance
- Staff training documentation mandatory