The Maryland Patient Plan of Care Form: Perceptions of Physicians and Social Workers

Objective: To assess nursing home physicians' and social workers' perceptions of the new Maryland Patient Plan of Care Form (PPOC). Design: Mailed survey. Setting: Nursing homes in Maryland. Participants: Thirty-seven physicians and 60 social workers. Measurements: Views of physicians and social workers were assessed through quantitative questions about the use of the PPOC form and qualitative questions about barriers in completing the form and recommendations to improve the form. Results: The majority (79.2%) of physicians and social workers reported that completing the PPOC is somewhat of a major burden. An overwhelming majority (85.6%) reported that social workers are completing the form, while close to half of the physicians and a quarter of the social work respondents say that physicians are involved in completing the form. Moreover, significantly more social workers (63.3%) than physicians (36.7%) believe the form would be more useful as a physician's order (X² = 5.287; d f = 1; P = .021). Both physicians and social workers identify barriers to completing the form and offer recommendations to improve the form. Conclusions: Despite legislation requiring physicians to sign the PPOC, it is not a physician's order, thus shifting the burden of completing the PPOC to social workers. We conclude that most physicians and social workers view the PPOC as burdensome and do not feel that it is useful, but whether it is having an effect on patient care preferences merits further investigation.