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Advanced care plan recording

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https://www.readbyqxmd.com/read/29101142/protocol-for-a-national-prevalence-study-of-advance-care-planning-documentation-and-self-reported-uptake-in-australia
#1
Rasa Ruseckaite, Karen M Detering, Sue M Evans, Veronica Perera, Lynne Walker, Craig Sinclair, Josephine M Clayton, Linda Nolte
INTRODUCTION: Advance care planning (ACP) is a process between a person, their family/carer(s) and healthcare providers that supports adults at any age or stage of health in understanding and sharing their personal values, life goals and preferences regarding future medical care. The Australian government funds a number of national initiatives aimed at increasing ACP uptake; however, there is currently no standardised Australian data on formal ACP documentation or self-reported uptake...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29063601/community-based-palliative-care-and-advance-care-planning-documentation-evidence-from-a-multispecialty-group
#2
Ming Tai-Seale, Yan Yang, Ellis Dillon, Sharon Tapper, Steve Lai, Peter Yu, Heather Allore, Christine Ritchie
BACKGROUND/OBJECTIVES: With the growing public demand for access to critical health data across care settings, it is essential that advance care planning (ACP) information be included in the electronic health record (EHR) so that multiple clinicians can access it and understand individuals' preferences for end-of-life care. Community-based palliative care programs often incorporate ACP services. This study examined whether a community-based palliative care program is associated with digitally extractable ACP documentation in the EHR...
October 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29040634/implementation-of-acute-care-patient-portals-recommendations-on-utility-and-use-from-six-early-adopters
#3
Lisa V Grossman, Sung W Choi, Sarah Collins, Patricia C Dykes, Kevin J O'Leary, Milisa Rizer, Philip Strong, Po-Yin Yen, David K Vawdrey
Objective: To provide recommendations on how to most effectively implement advanced features of acute care patient portals, including: (1) patient-provider communication, (2) care plan information, (3) clinical data viewing, (4) patient education, (5) patient safety, (6) caregiver access, and (7) hospital amenities. Recommendations: We summarize the experiences of 6 organizations that have implemented acute care portals, representing a variety of settings and technologies...
September 4, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29033272/graduating-surgical-residents-lack-competence-in-critical-care-ultrasound
#4
Renuka Tripu, Margaret H Lauerman, Daniel Haase, Syeda Fatima, Jacob Glaser, Cassandra Cardarelli, Thomas M Scalea, Sarah Murthi
OBJECTIVE: Ultrasound provides accessible imaging for bedside diagnostics and procedural guidance, but may lead to misdiagnosis in untrained users. The main objective of this study was to determine observed and self-perceived competence with critical care ultrasound in graduated general surgery residents. DESIGN: The design of this study was a retrospective review. Ultrasound training program records were reviewed for number of prior ultrasound examinations performed, self-perceived competence, observed competence on faculty examinations, and intended future use of individual critical care ultrasound examinations...
October 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28968585/treatment-and-prognosis-of-leptomeningeal-disease-secondary-to-metastatic-breast-cancer-a-single-centre-experience
#5
Belinda Kingston, Hamzeh Kayhanian, Chloe Brooks, Nicola Cox, Narda Chaabouni, Stefania Redana, Eleftheria Kalaitzaki, Ian Smith, Mary O'Brien, Stephen Johnston, Marina Parton, Jill Noble, Susie Stanway, Alistair Ring, Nicholas Turner, Alicia Okines
PURPOSE: Leptomeningeal disease (LMD) is an uncommon complication of advanced breast cancer. The prognosis is poor, and although radiotherapy (RT), systemic and intra-thecal (IT) chemotherapy are accepted treatment modalities, efficacy data are limited. This study was designed to evaluate potential predictors of survival in this patient group. METHODS: Breast cancer patients with LMD diagnosed by MRI in a 10-year period (2004-2014) were identified from electronic patient records...
December 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28964524/advanced-musculoskeletal-physiotherapists-in-post-arthroplasty-review-clinics-a-state-wide-implementation-program-evaluation
#6
Paula Harding, Angela Burge, Kerrie Walter, Bridget Shaw, Carolyn Page, Uyen Phan, Desiree Terrill, Susan Liew
OBJECTIVE: To evaluate outcomes following a state-wide implementation of post arthroplasty review (PAR) clinics for patients following total hip and knee arthroplasty, led by advanced musculoskeletal physiotherapists in collaboration with orthopaedic specialists. DESIGN AND SETTING: A prospective observational study analysed data collected by 10 implementation sites (five metropolitan and five regional/rural centres) between September 2014 and June 2015. MAIN OUTCOME MEASURES: The Victorian Innovation and Reform Impact Assessment Framework was used to assess efficiency, effectiveness (access to care, safety and quality, workforce capacity, utilisation of skill sets, patient and workforce satisfaction) and sustainability (stakeholder engagement, succession planning and availability of ongoing funding)...
August 30, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28955419/cervical-cancer-in-southern-malawi-a-prospective-analysis-of-presentation-management-and-outcomes
#7
Pandora Rudd, Dermot Gorman, Samuel Meja, Petani Mtonga, Yankho Jere, Irene Chidothe, Ausbert T Msusa, M Jane Bates, Ewan Brown, Leo Masamba
BACKGROUND: Malawi has the highest age standardised rate of cervical cancer in the world. This study describes the presentation, management and short-term outcomes of patients with newly diagnosed cervical cancer at Queen Elizabeth Central Hospital (QECH), in Southern Malawi. METHODS: All patients with a new diagnosis of cervical cancer presenting to QECH between 1st January-1st July 2015 had demographic data, referral pathway, stage, histology and management prospectively recorded at presentation, and at two months after initial presentation...
June 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28943360/advance-care-planning-documentation-practices-and-accessibility-in-the-electronic-health-record-implications-for-patient-safety
#8
Evan Walker, Ryan McMahan, Deborah Barnes, Mary Katen, Daniela Lamas, Rebecca Sudore
CONTEXT: Documenting patients' advance care planning wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about advance care planning documentation practices in the electronic health record. OBJECTIVES: Describe advance care planning documentation practices and the accessibility of documented discussions in the electronic health record. METHODS: Participants were primary care patients at the San Francisco VA Medical Center, were ≥60 years old, and had ≥2 chronic/serious health conditions...
September 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28939708/the-decisions-interventions-and-goals-in-implantable-cardioverter-defibrillator-therapy-dignity-pilot-study
#9
Daniel B Kramer, Daniel Habtemariam, Yaw Adjei-Poku, Michelle Samuel, Diane Engorn, Matthew R Reynolds, Susan L Mitchell
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) are commonly implanted in older patients, including those with multiple comorbidities. There are few prospective studies assessing the clinical course and end-of-life circumstances for these patients. METHODS AND RESULTS: We prospectively followed 51 patients with ICDs for up to 18 months to longitudinally assess in terms of (1) advance care planning, (2) health status, (3) healthcare utilization, and (4) end-of-life circumstances through quarterly phone interviews and electronic medical record review...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28932992/the-impact-of-a-primary-care-education-program-regarding-cancer-survivorship-care-plans-results-from-an-engineering-primary-care-and-oncology-collaborative-for-survivorship-health
#10
SarahMaria Donohue, James E Haine, Zhanhai Li, Elizabeth R Trowbridge, Sandra A Kamnetz, David A Feldstein, James M Sosman, Lee G Wilke, Mary E Sesto, Amye J Tevaarwerk
Survivorship care plans (SCPs) have been recommended as tools to improve care coordination and outcomes for cancer survivors. SCPs are increasingly being provided to survivors and their primary care providers. However, most primary care providers remain unaware of SCPs, limiting their potential benefit. Best practices for educating primary care providers regarding SCP existence and content are needed. We developed an education program to inform primary care providers of the existence, content, and potential uses for SCPs...
September 20, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28926294/predictors-of-death-in-the-hospital-for-patients-with-chronic-serious-illness
#11
Katy Hicks, Lois Downey, Ruth A Engelberg, James A Fausto, Helene Starks, Ben Dunlap, James Sibley, William Lober, Nita Khandelwal, Elizabeth T Loggers, J Randall Curtis
BACKGROUND: Most people prefer to die at home, yet most do not. Understanding factors associated with terminal hospitalization may inform interventions to improve care. OBJECTIVE: Among patients with chronic illness receiving care in a multihospital healthcare system, we identified the following: (1) predictors of death in any hospital; (2) predictors of death in a hospital outside the system; and (3) trends from 2010 to 2015. DESIGN: Retrospective cohort using death certificates and electronic health records...
September 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#12
Huzaifah Salat, Andrei Javier, Edward D Siew, Rocio Figueroa, Loren Lipworth, Edmond Kabagambe, Aihua Bian, Thomas G Stewart, Maie H El-Sourady, Mohana Karlekar, Cesar Y Cardona, T Alp Ikizler, Khaled Abdel-Kader
BACKGROUND AND OBJECTIVES: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Binary surprise question (i.e., "Would you be surprised if this patient died in the next 12 months?") responses were recorded, and dialysis planning preferences, presence of advance care planning documentation, and care preceding death were abstracted...
November 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28884703/definition-and-recommendations-for-advance-care-planning-an-international-consensus-supported-by-the-european-association-for-palliative-care
#13
REVIEW
Judith A C Rietjens, Rebecca L Sudore, Michael Connolly, Johannes J van Delden, Margaret A Drickamer, Mirjam Droger, Agnes van der Heide, Daren K Heyland, Dirk Houttekier, Daisy J A Janssen, Luciano Orsi, Sheila Payne, Jane Seymour, Ralf J Jox, Ida J Korfage
Advance care planning (ACP) is increasingly implemented in oncology and beyond, but a definition of ACP and recommendations concerning its use are lacking. We used a formal Delphi consensus process to help develop a definition of ACP and provide recommendations for its application. Of the 109 experts (82 from Europe, 16 from North America, and 11 from Australia) who rated the ACP definitions and its 41 recommendations, agreement for each definition or recommendation was between 68-100%. ACP was defined as the ability to enable individuals to define goals and preferences for future medical treatment and care, to discuss these goals and preferences with family and health-care providers, and to record and review these preferences if appropriate...
September 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28882812/health-information-technology-hit-adaptation-refocusing-on-the-journey-to-successful-hit-implementation
#14
Po-Yin Yen, Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Timothy R Huerta
In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines...
September 7, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28870384/top-ten-challenges-when-interfacing-a-laboratory-information-system-to-an-electronic-health-record-experience-at-a-large-academic-medical-center
#15
Athena K Petrides, Milenko J Tanasijevic, Ellen M Goonan, Adam B Landman, Michalis Kantartjis, David W Bates, Stacy E F Melanson
BACKGROUND: Recent U.S. government regulations incentivize implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR to their laboratory information system (LIS). Reported long-term benefits include increased efficiency and improved quality and safety. In order to successfully implement an interfaced EHR-LIS, institutions must plan years in advance and anticipate the impact of an integrated system...
October 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28865870/outcomes-that-define-successful-advance-care-planning-a-delphi-panel-consensus
#16
Rebecca L Sudore, Daren K Heyland, Hillary D Lum, Judith A C Rietjens, Ida J Korfage, Christine S Ritchie, Laura C Hanson, Diane E Meier, Steven Z Pantilat, Karl Lorenz, Michelle Howard, Michael J Green, Jessica E Simon, Mariko A Feuz, John J You
CONTEXT: Standardized outcomes that define successful advance care planning (ACP) are lacking. OBJECTIVE: To create an Organizing Framework of ACP outcome constructs and rate the importance of these outcomes. METHODS: This study convened a Delphi panel consisting of 52 multidisciplinary, international ACP experts including clinicians, researchers, and policy leaders from four countries. We conducted literature reviews and solicited attendee input from 5 international ACP conferences to identify initial ACP outcome constructs...
August 30, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28864448/discussion-and-documentation-of-future-care-a-before-and-after-study-examining-the-impact-of-an-alternative-approach-to-recording-treatment-decisions-on-advance-care-planning-in-an-acute-hospital
#17
Alexandra C Malyon, Julia R Forman, Jonathan P Fuld, Zoë Fritz
OBJECTIVE: To determine whether discussion and documentation of decisions about future care was improved following the introduction of a new approach to recording treatment decisions: the Universal Form of Treatment Options (UFTO). METHODS: Retrospective review of the medical records of patients who died within 90 days of admission to oncology or respiratory medicine wards over two 3-month periods, preimplementation and postimplementation of the UFTO. A sample size of 70 per group was required to provide 80% power to observe a change from 15% to 35% in discussion or documentation of advance care planning (ACP), using a two-sided test at the 5% significance level...
September 1, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28863160/high-rates-of-loss-to-follow-up-during-the-first-year-of-pre-antiretroviral-therapy-for-hiv-patients-at-sites-providing-pre-art-care-in-nigeria-2004-2012
#18
Simon G Agolory, Andrew F Auld, Solomon Odafe, Ray W Shiraishi, E Kainne Dokubo, Mahesh Swaminathan, Ibrahim Dalhatu, Dennis Onotu, Oseni Abiri, Henry Debem, Adebobola Bashorun, Tedd V Ellerbrock
BACKGROUND: With about 3.4 million HIV-infected persons, Nigeria has the second highest number of people living with HIV (PLHIV) in the world. However, antiretroviral treatment (ART) coverage in Nigeria remains low with only 748,846 (22%) of PLHIV on ART by the end of 2014. Retention of HIV-infected patients in pre-ART care is essential to ensure timely ART initiation. We assessed outcomes of patients enrolled in Nigeria's pre-ART program during 2004-2012. METHODS: We conducted a nationally representative retrospective cohort study among adults (≥15 years old), enrolling in pre-ART programs supported by the U...
2017: PloS One
https://www.readbyqxmd.com/read/28852789/a-multi-center-prospective-cohort-study-of-patient-transfers-from-the-intensive-care-unit-to-the-hospital-ward
#19
Henry T Stelfox, Jeanna Parsons Leigh, Peter M Dodek, Alexis F Turgeon, Alan J Forster, Francois Lamontagne, Rob A Fowler, Andrea Soo, Sean M Bagshaw
PURPOSE: To provide a 360-degree description of ICU-to-ward transfers. METHODS: Prospective cohort study of 451 adults transferred from a medical-surgical ICU to a hospital ward in 10 Canadian hospitals July 2014-January 2016. Transfer processes documented in the medical record. Patient (or delegate) and provider (ICU/ward physician/nurse) perspectives solicited by survey 24-72 h after transfer. RESULTS: Medical records (100%) and survey responses (ICU physicians-80%, ICU nurses-80%, ward physicians-46%, ward nurses-64%, patients-74%) were available for most transfers...
October 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28797865/increasing-advance-care-planning-completion-at-an-academic-internal-medicine-outpatient-clinic
#20
Ngoc-Phuong Luu, Candace Nigrin, Kimberly Peairs, Sydney M Dy, Melinda Sawyer, Samantha Pitts, Brent Petty
BACKGROUND: We sought to increase advance care planning completion at an academic internal medicine clinic through an electronic health record. MEASURES: Number of eligible patients who completed a form of advance care planning. INTERVENTION: Multidisciplinary team approach with engagement from providers and clinic staff; implemented informational letter and appropriate forms to eligible patients prior to appointment; informational video and provider reminders at time of appointment...
August 7, 2017: Journal of Pain and Symptom Management
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