Advance care planning helps to ensure that residents receive end-of-life care aligned with their goals. While research already shows that video interventions can improve advance care planning, understanding how nursing centers adopt such programs is an important next step to promoting widespread adoption. In the Brown study, nursing center staff adopted an advance-care planning video intervention as a new standard of care, while researchers examined process measures. This included how often staff offered residents a chance to view the videos.

Overall, staff offered to show the video to 69% of short-stay and 56% of long-stay residents. After taking into account different facility characteristics, the researchers found that centers with better 5-star ratings had higher “offer” rates than centers with 1 star rating. These findings suggest that nursing centers with lower star ratings may need support to successfully adopt this intervention.