Henke Charlotte, Mroz Emily, Le Ngoc Anh, Gregory Hannah M, Ghiaseddin Ashley, McFarland Nikolaus R, Baron-Lee Jacqueline
Department of Neurology, University of Florida, Gainesville, FL, USA.
These authors contributed equally to this work.
J Patient Exp. 2020 Dec;7(6):1286-1293. doi: 10.1177/2374373520932449. Epub 2020 Jun 23.
Patient-centered care includes delineation of patient treatment values (ie, advance care planning [ACP]). Advance care planning often includes advance directive (AD) completion and is underutilized, particularly among neurology and neurosurgery patients. Implementation of a supportive care team (SCT) in outpatient clinic settings may offer opportunities for AD education and completion.
This study assesses the effectiveness of an integrative SCT composed of hospice volunteers and undergraduate quality improvement interns in their efforts to provide ACP education in neurological and neurosurgical outpatient clinics. Assessment includes a description of different types of SCT-patient encounters, as well as patient interest in and completion of ADs after interacting with the SCT.
Across the data collection period, 2770 encounters were initiated. The majority of encounters resulted in patient ACP education. Some patients completed ADs during their SCT encounter (3.45%) or after their SCT encounter (10.18%).
The SCT effectively enhances ACP education in this patient population. The utilization of trained interns to assist with ACP is beneficial and practical in clinic workflow.
以患者为中心的护理包括明确患者的治疗价值观(即预先护理计划[ACP])。预先护理计划通常包括完成预先指示(AD),但目前利用不足,尤其是在神经病学和神经外科患者中。在门诊环境中实施支持性护理团队(SCT)可能为AD教育和完成提供机会。
本研究评估由临终关怀志愿者和本科质量改进实习生组成的综合SCT在神经科和神经外科门诊提供ACP教育方面的有效性。评估包括描述不同类型的SCT与患者的接触情况,以及患者在与SCT互动后对AD的兴趣和完成情况。
在数据收集期间,共发起了2770次接触。大多数接触都为患者提供了ACP教育。一些患者在与SCT接触期间(3.45%)或之后(10.18%)完成了AD。
SCT有效地加强了该患者群体的ACP教育。利用经过培训的实习生协助进行ACP在临床工作流程中是有益且切实可行的。