Concordance Between Veterans' Self-Report and Documentation of Surrogate Decision Makers: Implications for Quality Measurement
详细信息 查看全文
- 作者：Kimberly K. Garner ; MD ; JD ; MPH<sup>asup><sup> ; sup><sup>bsup><sup> ; sup><sup>garnerkimberlyk@uams.edusup> ; Patricia Dubbert ; PhD<sup>asup><sup> ; sup><sup>bsup> ; Shelly Lensing ; MS<sup>asup><sup> ; sup><sup>bsup> ; Dennis H. Sullivan ; MD<sup>asup><sup> ; sup><sup>bsup> ; the AAHPM Research Committee Writing GroupRebecca A. Aslakson ; MD ; PhD ; Katherine Ast ; MSW ; LCSW ; Ronit Elk ; PhD ; Kimberly K. Garner ; MD ; Robert Gramling ; MD ; DSc ; Corita Grudzen ; MD ; MSHS ; Arif H. Kamal ; MD ; MHS ; Sangeeta Lamba ; MD ; MSHPEd ; Thomas W. LeBlanc ; MD ; MA ; Ramona L. Rhodes ; MD ; MPH ; Eric Roeland ; MD ; Dena Schulman-Green ; PhD ; Kathleen T. Unroe ; MD ; MHA
- 关键词：Surrogate decision maker ; advance directive ; advance care planning ; quality improvement ; quality indicators ; palliative care ; communication
- 刊名：Journal of Pain and Symptom Management
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：53
- 期：1
- 页码：1-4
- 全文大小：102 K
- 卷排序：53
文摘
The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings.ObjectivesTo better understand the potential implementation of this Measuring What Matters quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker.MethodsExamination of patient responses to self-assessment questions from advance health care planning educational groups conducted in one medical center primary care clinic and seven community-based outpatient primary care clinics. We assessed the concordance between patient reports of identifying and naming a surrogate decision maker and having completed an advance directive (AD) with presence of an AD in the electronic medical record.ResultsOf veterans without a documented AD on file, more than half (66%) reported that they had talked with someone they trusted and nearly half (52%) reported that they had named someone to communicate their preferences.ConclusionsOur clinical project data suggest that many more veterans may have initiated communications with surrogate decision makers than is evident in the electronic medical record. System changes are needed to close the gap between veterans' plans for a surrogate decision maker and the documentation available to acute care health care providers.