Patient Safety Issues with End-of-life Care

Patient safety is too often an issue in end-of-life care. This is in part due to the high intensity care delivered towards the end of a patient’s life, against their wishes. Often, healthcare providers have not formally had an open advance care planning discussion involving the patient and their family. The result is uncertainty on the care path and treatment they would have wanted. When clinicians naturally default to life sustaining treatment, they typically extend suffering and involuntary pain for many seriously ill patients. The consequence: a breach in patient safety.

End-of-life and patient safety issues include:

  • Inappropriate pain medications
  • Medication errors
  • Inadequate pain management
  • Overmedication
  • Delirium
  • Falls
  • Pressure ulcers
  • Hospital-acquired infections
  • No bowel regimen for patients who experience constipation due to opiods
  • Treatments or procedures where risk exceeds benefits
  • Lack of communication between clinicians or the patient and family in the midst of a change in the patient’s condition or situation

People battling advanced or incurable diseases are often subjected to unimaginable pain and troubling symptoms. In agony, unable to voice their preferences, these patients are forced to endure prolonged suffering. This flaw in the US healthcare system simply doesn’t align with the overall goal of helping people live better lives, and so end-of-life care planning is considered a public health issue.

What Providers Know

In a Health and Retirement study, researchers collected data from patients designated proxies who vouched for their last days being incredibly difficult, in terms of the pain intensity and prevalence of burdensome symptoms. Nearly 80% of patients say they want to avoid hospitalization and high intensity care at end-of-life. Yet, studies show that these patients received care based on “the variables associated with their local health system, such as institutional capacity and the individual doctors’ practice style.” Interestingly, 88.3% of doctors that participated in an advance directive simulation chose to forego intensive medical treatment for themselves.

Providers know what their patients nearing the end-of-life experience, because they see it first hand. This is why majority of clinicians have solid advance care planning measures in place for themselves. For people who don’t have this knowledge or experience, the stigma associated with dying makes these conversations incredibly difficult. But, the most difficult conversations are always the most important.

Call to Action: Prioritize Advance Care Planning

To offset the the anticipated burden on our health care system and patients, Vynca created an end-to-end advance care planning solution. Knowing that EHR systems are not optimized to share accurate care plans when an emergency arises, Vynca has fostered partnerships with some of the largest EHR solutions to provide seamless integration for organizations, small and large. This enables quick access to a single source of truth for advance care planning documentation across the care continuum.

Our software supports and trains clinicians through the advance care planning process by providing a framework proven to ensure ACP success through education, conversation, technology and evaluation. Our solution enables healthcare organizations and providers to take crucial steps toward reducing ICU utilization and unnecessary hospitalizations, while increasing patient and family satisfaction, and achieving overall quality and value metrics.

Stigma is lessened with awareness and education. We walk clinicians through the best practices for advance care planning. We offer patient engagement tools, including video and reading content, to help patients understand the process. An evidence-based conversation guide helps clinicians navigate through this sensitive time.

Vynca was born out of necessity, and offers a simple solution to a very large problem. The silver tsunami is coming, and expected to be the largest public health challenge to date. By placing immediate urgency on adopting an advance care planning technology, organizations can help clinicians, patients, and family members better prepare for the inevitable.

To find out how you can prepare your organization for success email us at:

About the Author


Vynca, based in Palo Alto, Calif., provides comprehensive advance care planning technology solutions that enable health care organizations to deliver high-quality end-of-life care consistent with an individual’s preferences.

The company helps patients, families and health care providers have meaningful conversations about future care preferences, ensure that wishes are documented accurately and provides real-time access to this critical information throughout the care continuum.