Sinclair Craig, Mann Jill, Reymond Liz, Sansome Xanthe
School of Psychology, University of New South Wales, Sydney, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia.
Barwon Health Advance Care Planning Program, Geelong, Australia.
Z Evid Fortbild Qual Gesundhwes. 2023 Aug;180:111-114. doi: 10.1016/j.zefq.2023.05.012. Epub 2023 Jul 1.
Advance Care Planning in Australia has its foundations in the Respecting Patient Choices model, which was initially implemented in one state. The Australian population is diverse, ageing and geographically dispersed, with health and aged care services provided by a range of different organisations and regulated at different levels. Key challenges in ACP implementation include discomfort with ACP discussion, inconsistent legislation and ACP documentation across jurisdictions, poor quality control of ACP documents and difficulties accessing ACP documents at the point of care. The COVID-19 pandemic exposed a range of issues but also led to some innovative practices which have continued after the relaxation of public health restrictions. Ongoing implementation work focuses on meeting the needs of diverse communities and sectors in ACP, while seeking an overall coherence in policy and standardisation of practice through high-level best-practice principles, quality standards and policy frameworks.
澳大利亚的预立医疗计划以“尊重患者选择”模式为基础，该模式最初在一个州实施。澳大利亚人口多样、老龄化且地域分散，健康和老年护理服务由一系列不同组织提供，并在不同层面受到监管。预立医疗计划实施中的主要挑战包括对预立医疗计划讨论感到不适、各司法管辖区立法和预立医疗计划文件不一致、预立医疗计划文件质量控制不佳以及在医疗点获取预立医疗计划文件困难。新冠疫情暴露出一系列问题，但也催生了一些创新做法，这些做法在公共卫生限制放宽后仍在继续。正在进行的实施工作侧重于满足预立医疗计划中不同社区和部门的需求，同时通过高层次的最佳实践原则、质量标准和政策框架寻求政策的整体连贯性和实践的标准化。
