A quality improvement focus for patient rights: advance directives.

This article highlights the implementation and evaluation phases of specific mechanisms developed in a university hospital setting to comply with the Patient Self-Determination Act (PSDA) of 1991. The article describes the program within the context of a continuous quality improvement cycle beginning with a philosophy about patient involvement in health care decision making. The article takes the reader through each phase of the process, culminating in the development of a revised quality improvement plan.