An Integrated Approach to Selecting a Prepared Medical Decision-Maker.

Advance Care Planning Advance Directives Decision Making Electronic Health Records Humans Outpatients
Advance care planning advance directives cancer medical power of attorney prognosis surrogate medical decision-maker

Journal

Journal of pain and symptom management
ISSN: 1873-6513
Titre abrégé: J Pain Symptom Manage
Pays: United States
ID NLM: 8605836

Informations de publication

Date de publication:
06 2021
Historique:
received: 23 09 2020
revised: 01 12 2020
accepted: 04 12 2020
pubmed: 22 12 2020
medline: 10 7 2021
entrez: 21 12 2020
Statut: ppublish

Résumé

We implemented a systematic multidisciplinary process to engage new outpatients with cancer in selecting and preparing a medical decision-maker. Templated advance care planning notes and medical power of attorney documents were used in the electronic health record by the third office visit. Patients were coached to meet with social work from a "culture of yes," viewed a video about the importance of selecting a prepared medical a decision-maker in English or in Spanish, and referenced cards containing simple explanations of advance directives when responding to advance directive questions. A total of 351 patients were evaluated. By visit 3, there was no increase in documented social work advance care planning notes in intervention or scanned medical power of attorney documents in the electronic health record. This systematic multidisciplinary approach did not engage new outpatients with cancer in preparing a medical decision-maker. More active physician involvement and varied ways of engagement are needed.

Sections du résumé

BACKGROUND
We implemented a systematic multidisciplinary process to engage new outpatients with cancer in selecting and preparing a medical decision-maker.
MEASURES
Templated advance care planning notes and medical power of attorney documents were used in the electronic health record by the third office visit.
INTERVENTION
Patients were coached to meet with social work from a "culture of yes," viewed a video about the importance of selecting a prepared medical a decision-maker in English or in Spanish, and referenced cards containing simple explanations of advance directives when responding to advance directive questions.
OUTCOMES
A total of 351 patients were evaluated. By visit 3, there was no increase in documented social work advance care planning notes in intervention or scanned medical power of attorney documents in the electronic health record.
CONCLUSIONS/LESSONS LEARNED
This systematic multidisciplinary approach did not engage new outpatients with cancer in preparing a medical decision-maker. More active physician involvement and varied ways of engagement are needed.

Identifiants

DOI: 10.1016/j.jpainsymman.2020.12.006 PMID: 33348030
pubmed: 33348030
pii: S0885-3924(20)30938-6
doi: 10.1016/j.jpainsymman.2020.12.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1305-1310

Informations de copyright

Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Auteurs

Donna S Zhukovsky (DS)

Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. Electronic address: dzhukovs@mdanderson.org.

Ali Haider (A)

Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Janet L Williams (JL)

Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Baylor College of Medicine, Houston, Texas, USA.

Syed Naqvi (S)

Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Neeraj Joshi (N)

Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Loyola University Medical Center, Maywood, Illinois, USA.

Sarah Mills (S)

Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Dell Medical School, Austin, Texas, USA.

Pamela T Soliman (PT)

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Boby Mathew (B)

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Diane Bodurka (D)

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Larissa A Meyer (LA)

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Shannon Westin (S)

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Michael Frumovitz (M)

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Marisa B Nowitz (MB)

Department of Social Work, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA; The Trauma and Grief Center at The Hackett Center for Mental Health, Houston, Texas, USA.

LaShan Archie (L)

Department of Social Work, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Shauna Fenton (S)

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Kai Lang (K)

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Valentine Boving (V)

Department of Quality Management and Engineering, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Eduardo Bruera (E)

Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

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Classifications MeSH

questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Planification des soins du patient › Planification anticipée des soins › An Integrated Approach to Selecting a Prepared...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Planification des soins du patient › Planification anticipée des soins › Directives anticipées › An Integrated Approach to Selecting a Prepared...
questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Pensée (activité mentale) › Prise de décision › An Integrated Approach to Selecting a Prepared...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Documents › Dossiers médicaux › Systèmes informatisés de dossiers médicaux › Dossiers médicaux électroniques › An Integrated Approach to Selecting a Prepared...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › An Integrated Approach to Selecting a Prepared...
questionsmedicales.fr › Personnes › Patients › Patients en consultation externe › An Integrated Approach to Selecting a Prepared...