Advance care planning (ACP) has traditionally aimed at ensuring that patients’ end-of-life (EOL) wishes are understood and respected. However, recent literature raises concerns about its effectiveness, with many trials indicating that ACP does not significantly improve goal-concordant care, enhance quality of life or reduce healthcare costs. This is because patients’ future decisions are influenced by their transient preferences due to projection bias. To remain relevant, ACP requires a radical shift in perspective, implementation and branding. First, ACP’s mission must be redefined with a focus on: Educate, Share and Prepare. This perspective emphasises ongoing conversations about patient health and illness, sharing of patients’ current values and goals of care and preparation for the future, rather than making definitive future decisions. Second, ACP should be integrated into routine care, normalising these discussions. Simplifying ACP processes and shifting incentives to support shared responsibility among stakeholders can enhance integration. Last, rebranding ACP as ‘Advance Care Preparation’ can clarify its purpose, distinguishing it from EOL planning and increasing its uptake. This rebranding ensures that ACP meets the evolving needs of patients and their families, ultimately enhancing the quality of care and patient satisfaction. These changes in perspective, implementation and branding can transform ACP into a valuable tool for delivering compassionate, patient-centred healthcare, making it relevant to all individuals.

中文翻译：

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重新构想和重塑预先护理计划


预先护理计划 （ACP） 传统上旨在确保患者的临终 （EOL） 愿望得到理解和尊重。然而，最近的文献引起了对其有效性的担忧，许多试验表明 ACP 并没有显着改善目标一致性护理、提高生活质量或降低医疗保健成本。这是因为由于投射偏倚，患者的未来决定会受到他们的瞬态偏好的影响。为了保持相关性，ACP 需要在视角、实施和品牌方面发生根本性的转变。首先，必须重新定义 ACP 的使命，重点关注：教育、分享和准备。这种观点强调关于患者健康和疾病的持续对话，分享患者当前的价值观和护理目标，并为未来做准备，而不是做出明确的未来决定。其次，应将 ACP 纳入常规护理，使这些讨论正常化。简化 ACP 流程并改变激励措施以支持利益相关者之间的共同责任，可以增强整合。最后，将 ACP 更名为“Advance Care Preparation”可以阐明其目的，将其与 EOL 计划区分开来并提高其采用率。这种品牌重塑可确保 ACP 满足患者及其家人不断变化的需求，最终提高护理质量和患者满意度。这些观点、实施和品牌的变化可以将 ACP 转变为一种有价值的工具，提供富有同情心、以患者为中心的医疗保健，使其与所有人息息相关。