Increasing Medical Power of Attorney Completion for Hospitalized Patients During the COVID Pandemic: A Social Work Led Quality Improvement Intervention

Overview

Journal J Pain Symptom Manage

Publisher Elsevier

Specialties Critical Care
Pharmacology
Psychiatry

Date 2020 Dec 3

PMID 33271315

Citations 3

Authors

Sarguni Singh

Katie Herrmann

Wendy Cyriacks

Jeanie Youngwerth

Kathleen E Bickel

Hillary D Lum

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Situation, Education, Innovation, and Recommendation: A Large-Scale Systematic Review of Advance Care Planning in the Age of COVID-19.

Mayers T, Sakamoto A, Inokuchi R, Hanari K, Ring H, Tamiya N Healthcare (Basel). 2024; 12(6).

PMID: 38540631 PMC: 10970574. DOI: 10.3390/healthcare12060667.

Advanced care planning in the early phase of COVID-19: a rapid review of the practice and policy lessons learned.

Younan S, Cardona M, Sahay A, Willis E, Ni Chroinin D Front Health Serv. 2023; 3:1242413.

PMID: 37780404 PMC: 10541151. DOI: 10.3389/frhs.2023.1242413.

Implementation of advance care planning amid the COVID-19 crisis: A narrative review and synthesis.

Hirakawa Y, Saif-Ur-Rahman K, Aita K, Nishikawa M, Arai H, Miura H Geriatr Gerontol Int. 2021; 21(9):779-787.

PMID: 34318579 PMC: 8444945. DOI: 10.1111/ggi.14237.

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