Journal of pain and symptom management · 2026
Recognizing Quality Advance Care Planning Documentation: A Quality Improvement Initiative.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Carreras Maria Teresa Cruz, Senkel Mary, Luu Linda, Beno Jeff, Burk Kathryn, Cameron Brian, Dill Corbin, Benson Rani, Cabinte Paulette, Maffeu-Tamwo Florence, Raphel Smitha, Sudario Ryan, Thoppil Rekha, Sudario Polly, Soliman Maria, Nortje Nico
Аннотация
BACKGROUND: ACP documentation in oncology emergency care frequently fails to capture patient values, reasoning, and voice, limiting its clinical utility.
MEASURES: A five-domain ACP Documentation Quality Rubric (patient/family voice, goals/values, decision clarity, shared decision-making, plan integration) classified notes as Basic, Adequate, or Exemplary; the primary outcome was the proportion rated Exemplary.
INTERVENTION: Six components launched February 2026: provider education, exemplar dissemination, reviewer calibration, a point-of-care poster, unit champions, and formal kudos recognition of exemplary documentation.
OUTCOMES: Exemplary documentation rose from 14.98% (49/327) at baseline to 21.54% (129/599) post-intervention, a 43.7% relative increase exceeding the 15% target (p=0.016); inter-rater reliability improved (weighted kappa 0.41 to 0.53).
CONCLUSIONS/LESSONS LEARNED: Standardized rubrics paired with peer recognition can measurably improve ACP documentation quality in a high-acuity oncology setting; sustainability and downstream patient outcomes warrant further study.
MEASURES: A five-domain ACP Documentation Quality Rubric (patient/family voice, goals/values, decision clarity, shared decision-making, plan integration) classified notes as Basic, Adequate, or Exemplary; the primary outcome was the proportion rated Exemplary.
INTERVENTION: Six components launched February 2026: provider education, exemplar dissemination, reviewer calibration, a point-of-care poster, unit champions, and formal kudos recognition of exemplary documentation.
OUTCOMES: Exemplary documentation rose from 14.98% (49/327) at baseline to 21.54% (129/599) post-intervention, a 43.7% relative increase exceeding the 15% target (p=0.016); inter-rater reliability improved (weighted kappa 0.41 to 0.53).
CONCLUSIONS/LESSONS LEARNED: Standardized rubrics paired with peer recognition can measurably improve ACP documentation quality in a high-acuity oncology setting; sustainability and downstream patient outcomes warrant further study.