Internal Medicine 2019 Projects

Project Title: Advance Directives and Health Surrogacy in Low Income and Uninsured Populations: A Cross-Sectional study and QI Intervention

Faculty Mentor’s Name: Dr. Melanie Hagen
Phone: 352-222-4895
Email: melanie.hagen@medicine.ufl.edu

Student’s Name: Oliver Shore
Email: olivershore@ufl.edu

Project Description:

Our ability to communicate with patients is profoundly impacted by their health literacy. Limited health literacy is commonplace and associated with poor health outcomes including frequent readmissions and high mortality. Advance directives are an important tool in respecting patient autonomy in health care interventions. Advance directives can also reduce health care costs by avoiding unwanted, unnecessary care at the end of life. This aligns with an initiative underway at UF Health to improve the delivery of advance directives to our patients in the hospital as well as the outpatient clinics.


The aim of this current study is to enhance completion rates of advance directives by taking into consideration a patient’s health literacy level. Specifically, we are assessing the impact of an ambulatory intervention on the completion rate of advance directives for patients with adequate and limited health literacy. Our hypothesis is that both groups will benefit from the intervention, but patients with limited health literacy will show a greater improvement in the advance directives completion rate. We have completed enrolling patients and need to analyze the data to assess our hypothesis.