Initiating Advance Care Planning in Primary Care: A Model for Success
| Autor: | Jillian Gustin, Stephanie L. Leung, Barbara L Rose, Julie Childers |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Advance care planning Health Personnel Primary care Advance Care Planning 03 medical and health sciences 0302 clinical medicine Nursing 030502 gerontology Humans Medicine Referral and Consultation Qualitative Research General Nursing Aged Aged 80 and over Primary Health Care business.industry Communication Professional-Patient Relations General Medicine Middle Aged Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Practice Guidelines as Topic Female 0305 other medical science business |
| Zdroj: | Journal of Palliative Medicine. 22:427-431 |
| ISSN: | 1557-7740 1096-6218 |
| DOI: | 10.1089/jpm.2018.0380 |
| Popis: | Primary care physicians recognize the importance of advance care planning (ACP) conversations and report lack of training and time in the office to start them. Previous efforts have shown that ACP is a low-risk high-value intervention for older patients and those with life-limiting illness.To measure the impact of physician coaching and staff training with registered nurse (RN) support and electronic medical record (EMR) enhancements on the initiation of 2000 ACP conversations in primary care.Employing VitalTalkThere was an increase from zero at baseline in the number of ACP conversations and a leveling out of new ACP initiated each month. A total of 7200 ACP conversations were initiated for 31 months in 36 primary care practices, and 29% of conversations had advance directives scanned into the EMR during a 10-month review period. Most ACP conversations were initiated by RN care managers. In 2017, there were 7589 more ACP conversations initiated.By combining two complementary, evidenced-based curricula, providing support of a nurse liaison and designing a summary and alert in the EMR, this program exceeded its goal to initiate 2000 ACP conversations in primary care. Other health systems might consider a similar multicomponent intervention to increase ACP. |
| Databáze: | OpenAIRE |
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