2 Rekindling primary carers’ relationship with advance care planning: a quality improvement project

• DOI: 10.1136/bmjspcare-2019-asp.2
• Publication Date: 2020-05-08T03:27:27Z
• Authors: James Naughton; Huw Williams; Aoife Gleeson
• Keywords: PDCA; Thematic Analysis; Advance Care Planning; Facilitation

<h3>Background</h3> In 2017, a local priority setting exercise amongst stakeholders in palliative care identified gaps the documentation and communication of Advance Care Planning (ACP) as barriers to high quality care. We designed evaluated an electronic template-based intervention empower primary teams overcome these challenges. <h3>Aims</h3> aimed increase recording ACP discussions. This was via (1) development reporting toolkit (2) evaluation using Quality Improvement (QI) methods. <h3>Methods</h3> Six practices were recruited for 6 month QI project. Practices supported through educational sessions facilitation from study team. Utilising regular feedback repeated PDSA cycles, template adjusted maximise usability impact. Monthly reports with comparative statistics shared practices. collected continuous data over 12 period (6 months baseline data). Data template's inbuilt module, participant interviews, research team's observations practices' after death reviews. Run charts utilised correlate trends timing interventions such monthly education sessions. Thematic analysis applied interviews project participants. <h3>Results/conclusion</h3> A tenfold preferred place demonstrated during period. Documentation resuscitation wishes increased by 42% documented anticipatory prescribing 9-fold. Further work will establish impact on patient outcomes apply lessons learned scale-up efforts. Challenges include: engaging ACP; design scalability e-solutions managing patients; adequately resourcing this ensure sustainability.