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J Pain Symptom Manage ; 61(3): 579-584.e1, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33271315

RESUMO

BACKGROUND: The high risk of mechanical ventilation with COVID hospitalizations requires health-care systems to rapidly innovate advance care planning (ACP) delivery for hospitalized patients to promote goal-concordant care. MEASURES: Assess the impact of a social work and care management intervention on the proportion of admitted patients each week with a Medical Durable Power of Attorney (MDPOA). INTERVENTION: Social workers were consulted to assist with identification of a surrogate decision maker and completion of MDPOA forms for hospitalized patients. This intervention utilized change management strategies and was implemented between April and June 2020. OUTCOMES: From a baseline average of 30.1%, the weekly percentage of admitted patients with MDPOA forms rose to 42.8% with correlating evidence of nonrandom special cause variation. LESSONS LEARNED: Use of change management strategies resulted in rapid implementation of an effective ACP initiative. Ongoing needs include focusing on intervention sustainability and education of interprofessional providers about ACP processes.


Assuntos
Planejamento Antecipado de Cuidados/organização & administração , Diretivas Antecipadas , COVID-19 , Hospitalização , Testamentos Quanto à Vida , Melhoria de Qualidade , Registros Eletrônicos de Saúde , Humanos , Pandemias , Planejamento de Assistência ao Paciente , Serviço Social
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