Background In unprecedented and the most aged society, Japan, Ministry of Health, Labour and Welfare is constructing the Integrated Community Care System (ICCS) for the elderly to continue living in their own hometown through to the end with a sense of security. For establishment of ICCS, provision of high-quality end-of-life care (EOLC) is essential. Gold Standards Framework (GSF) has improved quality, cordination and outcomes of EOLC in UK.
Aim To construct ICCS based on appropriate EOLC system in Japan by implementation of GSF.
Methods 1. Visit to the GSF centre and learn about training programs, toolkits, assessment and accreditation system for assurance of EOLC quality. 2. Translation of GSF strategy into Japanese version (GSF-J) and adoptation into EOLC system which incorporated within ICCS. 3. Promotion of workshop for GSF-J for health care workers, patients and families at communities close to National Centre for Geriatrics and Gerontology. 4. Development of GSF-J with the Train-the-Trainer Strategy on nationwide.
Results GSF adopts the 3 Steps; 1. Identification of the Gold Patient at EOL based on view of the patients using the Prognosis Indicator Guidance with the Surprise Question, 2. Assessment leading to Advance Care Planning, 3. Plan for the Gold Patient. They promote avoidance of unplanned admissions for enabling to live and die at desirable place of choice and reducing hospital death and health care cost.
Conclusion Implementation of GSF-J enables to improve quality of patient-centred EOLC, which leads to assurance for a sense of security of the elderly in ICCS, Japan.
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