Health System Intervention to Innovate and Improve Advance Care Planning for Older Adults.

IF 3.5 2区医学 Q2 CLINICAL NEUROLOGY

Journal of pain and symptom management Pub Date : 2025-09-01 DOI:10.1016/j.jpainsymman.2025.08.029

Katherine Aragon, Brian S Wood, Karen Halpert, Aaron J Miller, Stephanie Turner, Kinsey Brady, Laura C Hanson

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引用次数: 0

Abstract

Background: Advance care planning (ACP) conversations happen infrequently even for patients with serious illness. Because patients are seen across settings, a unified approach to ACP is important in large integrated health systems.

Measures: To describe the structural and clinical process changes implemented by a large health system to improve and expand ACP for older adults.

Intervention: UNC Health, a large academic public health system, created the ACP Taskforce to develop and implement a plan to document, facilitate, and educate to expand ACP across entities for patients 65 years and older.

Outcomes: Between July 2019 to June 2022, the percentage of patients 65 years and older with any ACP documentation increased from 63% to 72.2%. ACP documentation shifted over that time to documenting health care decision makers and completing ACP notes.

Conclusion/lessons learned: Aligning ACP across a large health system was facilitated by representation across entities and resulted in improved ACP practices.

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卫生系统干预创新和改进老年人的提前护理计划。

背景：提前护理计划（ACP）对话很少发生，即使是严重疾病的患者。由于患者是在不同的环境中就诊的，因此在大型综合卫生系统中，采用统一的ACP方法非常重要。目的：描述大型卫生系统为改善和扩大老年人ACP而实施的结构和临床过程变化。方法：UNC Health是一个大型学术公共卫生系统，创建了ACP工作组来制定和实施一项计划，以记录、促进和教育65岁及以上患者跨实体扩展ACP。结果：在2019年7月至2022年6月期间，65岁及以上有ACP记录的患者比例从63%增加到72.2%。ACP的文件在那段时间里转变为记录医疗保健决策者和完成ACP笔记。结论：跨实体的代表促进了在大型卫生系统中调整ACP，并导致了ACP实践的改进。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pain and symptom management 医学-临床神经学

CiteScore

8.90

自引率

6.40%

发文量

821

审稿时长

26 days

期刊介绍： The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.