Handout 5.1 Developing a Refined Improvement Goal ETHICS ISSUE 1: Shared Decision Making with Patients—Advance Care Planning 2. Ethical 3. Ethical 4. Best 5. Metric 6. Current 7. Reality 8. Achievable 9. Refined 1. Ethics Issue Standard Standard Practice Ethics Check Goal Improvement Source(s) Description(s) Practice Goal “Should” “Is” with A recent VHA Handbook VHA Handbook Primary care Numerator: Current ethics 1. Starting 1004.2 states that patients who practice was Point The number of review of Care request determined primary care care Planning and information with based on a provided health records Management of about advance completing of 30 with assistance found that only Advance directives an advance primary care as measured by a few patient and/or directive patient health a note template requests for in should records. 2. Seriousness completed by a assistance with completing the it social worker or Currently, 10% completing an forms must be [unless someone equally of primary care advance provided for all change trained patients who were patients who their minds ____________ have a followed up on request this about their request Denominator: by clinic staff. service. requests for 3. Environment for assistance assistance, Total number of Exclusion(s): with completing withdraw primary care Patients who an advance from the who change their directive Health Care requested minds about it. System, or with their requests who now lack completing an for assistance, 4. Challenge advance directive who withdraw from the Health Method: Care System, Record review or who now Sample size: 30 lack Time frame for data collection: 1 week
Handout 5.1 Developing a Refined Improvement Goal ETHICS ISSUE 1: Shared Decision Making with Patients—Advance Care Planning 1. Ethics Issue 2. Ethical Standard Source(s) 3. Ethical Standard Description(s) with 4. Best 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 states that information about advance directives and/or in completing the forms must be provided for all patients who request this service. Exclusion(s): Patients who change their minds about their requests for assistance, who withdraw from the Health Care System, or who now lack Primary care patients who request with completing an advance directive should it [unless change their minds about their requests for assistance, withdraw from the Health Care System, or who now lack Numerator: The number of primary care provided with assistance as measured by a note template completed by a social worker or someone equally trained ____________ Denominator: Total number of primary care who requested with completing an advance directive Method: Record review Sample size: 30 Time frame for data collection: 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 directive it. 1. Starting Point 2. Seriousness 3. Environment 4. Challenge
pe_btb_mod5_handouts_final_06162014.docx