Evaluation of Quality Improvement Initiatives to Improve and Sustain Advance Care Planning Completion and Documentation
Evaluation of Quality Improvement Initiatives to Improve and Sustain Advance Care Planning Completion and Documentation
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DOI：
10.1097/njh.0000000000000490
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发表时间：
2019-02-01
影响因子：
1.8
通讯作者：
Lum, Hillary D.
中科院分区：
文献类型：
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作者：
Fink, Regina M.;Somes, Elizabeth;Lum, Hillary D.
尽管预先护理计划（ACP）具有既定的好处，但在许多卫生保健机构中，实现和维持高的ACP完成率仍然是一个挑战。一个姑息治疗冠军委员会的目标是通过学术医疗中心的质量改进举措来改善ACP进程。为了了解多年来努力改善ACP的影响，2013年和2017年对住院和门诊的注册护士、护理协调员和医疗助理进行了调查，以探讨ACP的舒适度、日常实践中阻碍完成ACP的障碍，以及克服这些障碍的建议。研究结果提出了通过跨学科团队进一步整合ACP的策略，包括门诊人员教育，住院和门诊质量改善举措，以及ACP的专门人员。
Despite the established benefit of advance care planning (ACP), achieving and sustaining high rates of ACP completion continue to be a challenge in many health care settings. A palliative care champions committee has targeted improving the ACP process through quality improvement initiatives at an academic medical center. To understand the impact of multiyear efforts to improve ACP, surveys of registered nurses, care coordinators, and medical assistants from inpatient and outpatient settings were conducted in 2013 and 2017 to explore comfort level with ACP, barriers preventing completion of ACP in daily practice, and suggestions for overcoming these barriers. The findings suggest strategies to further integrate ACP through interdisciplinary teams, including outpatient staff education, inpatient and outpatient quality improvement initiatives, and dedicated staff for ACP.