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提高新加坡一家三级风湿病中心的预先医疗指示完成率：一项质量改进项目。

Improving completion rate of advance care planning at a tertiary rheumatological centre in Singapore: a quality improvement project.

机构信息

Department of Rheumatology and Immunology, Singapore General Hospital, Singapore

Internal Medicine Residency, SingHealth Group, Singapore.

出版信息

BMJ Open Qual. 2024 Oct 14;13(4):e002897. doi: 10.1136/bmjoq-2024-002897.

DOI:10.1136/bmjoq-2024-002897
PMID:39401969
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11474902/
Abstract

Advanced care planning (ACP) is a series of ongoing voluntary discussions between patients, families and healthcare professionals to plan for their future healthcare needs. Despite patients with rheumatic diseases having high symptom burden and disease complications, the ACP completion rates in patients with rheumatic diseases remain low. In this quality improvement project, we aimed to increase the number of completed ACP in a tertiary referral rheumatology centre in Singapore from 0 to 1 per month. We showed a statistically significant increase in ACP completion across 1 year with two Plan-Do-Study-Act cycles. Further studies are needed to explore further interventions for ACP completion in patients with rheumatic diseases.

摘要

高级医疗照护计划（ACP）是患者、家属和医疗保健专业人员之间持续进行的一系列自愿性讨论，旨在规划未来的医疗保健需求。尽管患有风湿性疾病的患者症状负担和疾病并发症较高，但风湿性疾病患者的 ACP 完成率仍然很低。在这个质量改进项目中，我们旨在将新加坡一家三级转诊风湿病中心的 ACP 完成数量从每月 0 增加到 1。通过两个计划-执行-研究-行动循环，我们在一年内显示出 ACP 完成数量的统计学显著增加。需要进一步的研究来探索风湿性疾病患者完成 ACP 的进一步干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c11/11474902/a8e912748a9e/bmjoq-13-4-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c11/11474902/a8e912748a9e/bmjoq-13-4-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c11/11474902/a8e912748a9e/bmjoq-13-4-g001.jpg

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本文引用的文献

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BMC Palliat Care. 2022 Nov 22;21(1):203. doi: 10.1186/s12904-022-01099-9.
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All-cause mortality in systemic rheumatic diseases under treatment compared with the general population, 2015-2019.
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Arthritis Res Ther. 2019 Apr 3;21(1):86. doi: 10.1186/s13075-019-1867-1.
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Semin Arthritis Rheum. 2019 Aug;49(1):156-161. doi: 10.1016/j.semarthrit.2018.10.020. Epub 2018 Nov 2.
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