PDF(Pubmed)
Abstract：
In New York State, the Health Care Proxy Law allows patients to designate a person they trust to make medical decisions on their behalf should they lose the capacity to do so. In an Intensive Care Unit (ICU) setting, identification of a health care proxy (HCP) is especially important as patients are at heightened risk of losing decision-making capacity during their clinical course. While our hospital has guidelines to solicit and correctly document the patient\'s HCP information, it is not routinely done. Missing or incomplete HCP documentation is a prevalent issue, with lack of patient education, physical document issues, and time and workflow constraints commonly cited as barriers. We describe the implementation of a small-scale quality improvement project to increase the percentage of completed HCP documentation in our ICU through multi-faceted interventions targeting education, workflow, access, and technology.
摘要：
在纽约州,《医疗保健代理法》允许患者在失去能力的情况下指定他们信任的人代表他们做出医疗决定。在重症监护病房(ICU)设置中，医疗保健代理(HCP)的识别尤为重要,因为患者在临床过程中失去决策能力的风险更高.虽然我们医院有指南来征求和正确记录患者的HCP信息，这不是常规的。缺少或不完整的HCP文档是一个普遍存在的问题，缺乏病人的教育，物理文档问题，以及通常被称为障碍的时间和工作流程限制。Wedescribetheimplementationofasmall-scalequalityimprovementprojecttoincreasethepercentageofcompletedHCPdocumentationinourICUthroughmulti-diversiveinterventionstargetededucation,工作流,access,和技术。
