Handout 5.4 Developing a Refined Improvement Goal—Answer Keys ETHICS ISSUE 1: Shared Decision Making with Patients—Advance Care Planning 2. Ethical 3. Ethical 4. Best Ethics 5. Metric 6. Current 7. Reality Check 8. Achievable 9. Refined 1. Ethics Standard Standard Practice Ethics Goal Improvement Source(s) Description(s) Practice Goal “Should” “Is” with Exclusions A recent VHA Handbook VHA Handbook Primary care Numerator: Current ethics 1. Based on 90% of primary Increase the % 1004.2 indicates that patients who practice was accreditation care patients of primary care The number of review of Care additional request determined is required and who request patients who primary care care Planning and about with based on a monitored; starting with receive patients health records Management of advance completing an of 30 point is 90%. completing an assistance with found that only Advance and/or advance primary care advance with completing assistance as 2. Although a serious a few patient assistance in should patient health will an advance measured by a issue, it is tolerable to requests for completing the receive it [unless records. receive it. from 10% note template miss providing assistance with forms must be patients change to 90% by Q4, completed by a Currently, 10% of as there are completing an provided for all their minds about 20XX. social worker or primary care additional advance patients who their requests for someone patients who to address and were request this assistance, trained have a assist with completing followed up on from the ____________ request advance directives by clinic staff. Health Care Exclusion(s): for assistance when a patient is Denominator: or who now Patients who with completing to an inpatient lack Total number of change their an advance setting. primary care minds about their receive it. patients who 3. Leadership support requests for requested should be evident due who with to accreditation withdraw from completing an the Health Care advance System, or who 4. Challenge goal now lack could be any % Method: above 90%. capacity. Record review Sample size: 30 Time frame for data 1 week
Handout 5.4 Developing a Refined Improvement Goal—Answer Keys ETHICS ISSUE 1: Shared Decision Making with Patients—Advance Care Planning 1. Ethics 2. Ethical Standard Source(s) 3. Ethical Standard Description(s) with Exclusions 4. Best Ethics Practice “Should” 5. Metric 6. Current Ethics Practice “Is” 7. Reality Check 8. Achievable Goal 9. Refined Improvement Goal A recent review of care health records found that only a few patient requests for assistance with completing an advance were followed up on by clinic staff. VHA Handbook 1004.2 Care Planning and Management of Advance VHA Handbook indicates that additional about advance and/or assistance in completing the forms must be provided for all patients who request this Exclusion(s): Patients who change their minds about their requests for who withdraw from the Health Care System, or who now lack capacity. Primary care patients who request with completing an advance should receive it [unless patients change their minds about their requests for assistance, from the Health Care or who now lack Numerator: The number of primary care patients with assistance as measured by a note template completed by a social worker or someone trained ____________ Denominator: Total number of primary care patients who requested with completing an advance Method: Record review Sample size: 30 Time frame for data 1 week Current ethics practice was determined based on a of 30 primary care patient health records. Currently, 10% of primary care patients who have a request for assistance with completing an advance receive it. 1. Based on accreditation is required and monitored; starting point is 90%. 2. Although a serious issue, it is tolerable to miss providing as there are additional to address and assist with completing advance directives when a patient is to an inpatient setting. 3. Leadership support should be evident due to accreditation 4. Challenge goal could be any % above 90%. 90% of primary care patients who request with completing an advance will receive it. Increase the % of primary care patients who receive assistance with completing an advance from 10% to 90% by Q4, 20XX.
pe_btb_mod5_handouts_final_06162014.docx