The Qualy Observatory-World Health Organization Collaborating Center for Public Health Palliative Care Programs (WHOCC-ICO), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.
Chair of Palliative Care, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain.
Palliat Support Care. 2019 Aug;17(4):415-424. doi: 10.1017/S1478951518000561.
Implementation of an advance care planning (ACP) program for people with advanced chronic conditions is a complex process. The aims of this paper are to describe (1) the development of the ACP program in Catalonia, Spain, for patients with advanced chronic conditions and complex needs and (2) the preliminary results of the implementation of this program in health and social services.
The ACP program was developed and implemented in a four-stage process as follows: (1) design and organization of the project; (2) selection of the professionals to carry out the project; (3) creation of four working groups to develop the conceptual model, guidelines, training program, and perform a qualitative evaluation; and (4) project implementation.
The following deliverables were completed: (1) conceptual framework document; (2) practical guidelines for the application of the ACP; (3) online training course (3,763 healthcare professionals completed the online course, with an overall satisfaction rating of 8.4 on a 10-point scale); and (4) additional training activities (conferences, short courses, and seminars) in between 2015 and 2017.
This project was led by the Catalan Ministry of Health. The strengths of the project development include the contribution of a wide range of professionals from the entire region, approval by the Catalan Bioethics Committee and the Social Services Ethics Committee, and the ongoing validation by members of the community. A standardized online training course was offered to all primary care professionals and included as a quality indicator for continuing education for those professionals in the period 2016-2020. The main outcome of this project is the establishment of a pragmatic ACP throughout the region and training of the health and social care professionals involved in the care of advanced chronic patients.
为患有晚期慢性疾病和复杂需求的患者实施预先护理计划（ACP）项目是一个复杂的过程。本文的目的是描述（1）西班牙加泰罗尼亚为患有晚期慢性疾病和复杂需求的患者制定和实施 ACP 计划的过程，以及（2）该计划在卫生和社会服务中的初步实施结果。
ACP 计划是分四个阶段开发和实施的，具体如下：（1）项目设计与组织；（2）选择开展项目的专业人员；（3）创建四个工作组，以制定概念模型、指南、培训计划，并进行定性评估；（4）项目实施。
完成了以下成果：（1）概念框架文件；（2）ACP 应用实践指南；（3）在线培训课程（3763 名医疗保健专业人员完成了在线课程，整体满意度评分为 10 分制的 8.4 分）；以及（4）2015 年至 2017 年期间开展的额外培训活动（会议、短期课程和研讨会）。
该项目由加泰罗尼亚卫生部牵头。项目开发的优势包括来自该地区各个专业领域的广泛专业人员的参与、加泰罗尼亚生物伦理委员会和社会服务伦理委员会的批准，以及社区成员的持续验证。提供了一个标准化的在线培训课程，供所有初级保健专业人员使用，并将其作为 2016-2020 年期间这些专业人员继续教育的质量指标之一。该项目的主要成果是在整个地区建立了实用的 ACP，并培训了参与晚期慢性患者护理的卫生和社会保健专业人员。
