The SUPPORT Project and Improving Care for Seriously III Patients

Greg A. Sachs, MD
JAMA. 1996;275(16):1229. doi:10.1001/jama.1996.03530400015023.
Text Size: A A A
Published online

To the Editor.  —The similarity between the SUPPORT1 intervention and the way many hospitals responded to the Patient Self-determination Act (PSDA) is striking.2 Many hospitals' PSDA policies use clerks, nurses, social workers, and other nonphysician staff to promote advance directive use, often without significant impact. Physicians remain disengaged from these PSDA efforts. The advance directive effort appears to be tolerated by physicians almost because they expect it to have little impact on their usual practice. Likewise, the SUPPORT intervention used computer models, written materials for the medical record, and nurse specialists. Despite the participating physicians' willingness to be part of SUPPORT, I wonder if they simply tolerated the intervention because it did not interfere too much with existing practice, rather than being committed to improving the designated outcomes. It would be interesting to have had a measure that reflected the extent to which participating physicians embraced the notion


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.