Hi Maria,
It would be useful to be more detailed in your consideration of outcome and process measures that could be used to evaluate your intervention to improve advance directive documentation. Many of the indicators you list I think reflect impact (program goals), rather than outcomes (program objectives) or process (program activities).
I assume the objectives of your intervention might include:
1. To increase documentation of an advance directive in the medical chart
2. To increase the proportion of patients (? elderly) who have had advance directive discussions during at least one clinical encounter
Activities are the intervention components you will use to achieve the objectives. A good way to think about process measures is that they should reflect the barrier(s) the intervention is targeting. Based on your previous assignment, process measures that reflect the successful implementation of your intervention (patient education, informational posters, MyChart reminders, etc) might include:
1. Proportion of patients who know what an advance directive is
2. Proportion of patients who know how to access an advance directive document
3. Proportion of patients who report seeing information about advance directives in clinic waiting areas or rooms
4. Proportion of patients who report reviewing the MyChart reminder/message
And so on. The process measures are critical to understand whether your intervention was implemented successfully and modified the barriers you assumed it would target. You start to get at how you would assess this in your response to Question 2, but would be more detailed about outcome measures (which reflect whether program objectives were achieved) and process measures (which reflect whether program activities were implemented and if so whether they were successful).