Advance Care Planning in the Inpatient Setting: The Role of the Hospitalist

Abstract

Advance care planning (ACP) is critical to patient-centered health care, particularly in hospital settings where acute and end-of-life decisions often occur. As frontline providers, hospitalists are uniquely positioned to initiate and guide ACP discussions. This article explores the role of hospitalists in ACP, identifies barriers to its implementation, and highlights strategies to overcome these challenges. Key barriers include time constraints, lack of formal training, and uncertainty regarding the appropriate timing of discussions. To address these issues, hospitalists can benefit from structured communication training, integration of ACP prompts into electronic health records, and collaboration with multidisciplinary teams. While ACP has demonstrated benefits, including the alignment of care with patient preferences, reduced unnecessary interventions, and improved satisfaction for patients and families, challenges remain in ensuring consistent and culturally sensitive implementation. This article also examines the ongoing debate regarding the advantages of ACP, balancing its potential to enhance care with concerns about emotional discomfort and operational barriers. Ultimately, ACP represents a pivotal opportunity to advance patient autonomy and deliver compassionate care. By addressing barriers and leveraging institutional and policy-level support, hospitalists can lead the charge in making ACP a standard and meaningful aspect of health care delivery.