In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 27_suppl ( 2019-09-20), p. 42-42
Kurzfassung:
42 Background: Advance Directive (AD) completion is particularly more important in patients with cancer given the higher mortality associated with the diagnoses as well as the treatments that patients receive. In reality AD discussion and completion rate is influenced by patient characteristics and disease status. We undertook a Quality improvement project to improve AD discussion and completion in inpatient hematology unit at our institution. Methods: Plan-Do-Study-Act (PDSA) methodology was used and the team consisted of residents and case managers. Each morning electronic medical record (EMR) was reviewed and new patients admitted to hematology unit were identified for a period of 1 month. Patients without an AD on file were educated by a designated resident and were given forms to file AD. Based on the patient’s willingness, the case manager was alerted with daily communication email to follow-up and assist in completion and filing of AD into EMRs. Results: AD on discharge on a randomly chosen pre-intervention month was 6.97% which improved to 42% post intervention. Conclusions: Compared to Oncology patients, Hematology patients have a lower rate of AD completion in general. Hematology patients are usually younger, have a higher chance of achieving remission, and usually have improved survival with stem cell transplant due to which AD discussion does not happen very often. The notion of having AD discussion only for patients with poor prognosis should change and must be offered to everyone. We found an improvement in AD filing rate by increasing physician involvement and streamlining the process with designated roles. It is the responsibility of physicians to discuss Advance Care Planning (ACP) with their patients and readdress them at appropriate intervals as disease status can change. [Table: see text]
Materialart:
Online-Ressource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2019.37.27_suppl.42
Sprache:
Englisch
Verlag:
American Society of Clinical Oncology (ASCO)
Publikationsdatum:
2019
ZDB Id:
2005181-5
