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Outcomes of a 3-Year Quality Improvement Study to Improve Advance Care Planning in Patients With Decompensated Cirrhosis.
Patel, Arpan; Bowman, Chip A; Prause, Nicole; Kilaru, Saikiran M; Nguyen, Andrew; Kogekar, Nina; Cohen, Cynthia; Channen, Lindsay; Harty, Alyson; Perumalswami, Ponni; Dietrich, Douglas; Schiano, Thomas; Woodrell, Christopher; Agarwal, Ritu.
Afiliação
  • Patel A; Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
  • Bowman CA; Department of Gastroenterology, Hepatology, and Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
  • Prause N; Division of Digestive and Liver Diseases, Department of Medicine, Columbia University New York Presbyterian Hospital, New York, New York, USA.
  • Kilaru SM; Division of Digestive Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
  • Nguyen A; Division of Gastroenterology and Hepatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
  • Kogekar N; Department of Gastroenterology and Hepatology, Kaiser Permanente Washington, Seattle, Washington, USA.
  • Cohen C; Division of Gastroenterology, Montefiore Medical Center, Bronx, New York, USA.
  • Channen L; Division of Gastroenterology and Hepatology, Westchester Medical Center.
  • Harty A; Warren Alpert Medical School of Brown University in Providence, Providence, Rhode Island, USA.
  • Perumalswami P; Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Dietrich D; Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.
  • Schiano T; Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Woodrell C; Recanati Miller Transplant Institute, Mount Sinai Hospital, New York, New York, USA.
  • Agarwal R; Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Am J Gastroenterol ; 2023 Dec 11.
Article em En | MEDLINE | ID: mdl-37934193
INTRODUCTION: To report outcomes of a 3-year quality improvement pilot study to improve advance directive (AD) completion. METHODS: The pilot consisted of champions, education, electronic health record templates, and workflow changes. We assessed changes, predictors, and effects of AD completion. RESULTS: The pilot led to greater (8.3%-36%) and earlier AD completion, particularly among those divorced, with alcohol-associated liver disease, and with higher Model of End-Stage Liver Disease-Sodium score. Decedents whose AD specified nonaggressive goals experienced lower hospital lengths of stay. DISCUSSION: Advance care planning initiatives are feasible and may reduce health care utilization among decedents requesting less aggressive care.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article
Texto completo
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PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article