MBBS BSc (Med) (Hons), FRACGP, General Practitioner, Church Street Medical Practice, Newtown, NSW
MBBS, MBioethics, FRACGP, FAChPM, Palliative Medicine Physician, St Vincent’s Hospital, Melbourne, Vic; Research Fellow, VCCC Palliative Medicine Research Group
Aust J Gen Pract. 2018 Nov;47(11):753-757. doi: 10.31128/AJGP-06-18-4613.
Advance care planning (ACP) is an important component of quality care for patients with chronic and advanced diseases. General practititoners are ideally placed to initiate ACP because of their role in care coordination of chronic and advanced diseases, and the longstanding relationship they develop with patients.
This paper outlines the key barriers to general practice involvement in ACP and describes useful strategies for incorporating ACP into patient care.
Barriers to ACP are many and involve health professionals, patients and the healthcare system. To successfully incorporate ACP into patient care, there should be: (i) a commitment from the whole practice to incorporate ACP into patient care; (ii) a focus on building capacity for ACP in the practice; and (iii) efforts to implement and optimise the process of ACP. The outcomes of ACP (eg Advance Care Directives) should be disseminated appropriately to enable them to improve patient care.
预先医疗指示（ACP）是为患有慢性和晚期疾病的患者提供优质护理的重要组成部分。由于全科医生在慢性病和晚期疾病的护理协调方面的作用，以及他们与患者建立的长期关系，他们非常适合启动 ACP。
本文概述了全科医生参与 ACP 的主要障碍，并描述了将 ACP 纳入患者护理的有用策略。
ACP 的障碍很多，涉及卫生专业人员、患者和医疗保健系统。要成功地将 ACP 纳入患者护理，应该：（i）整个实践承诺将 ACP 纳入患者护理；（ii）专注于在实践中建立 ACP 能力；（iii）努力实施和优化 ACP 流程。应适当地传播 ACP 的结果（例如预先医疗指示），以提高患者的护理质量。
