Schofield, G;
Kreeger, L;
Meyer, M;
Swann, D;
Wijeratne, A;
Wood, J;
Stone, P;
(2015)
Implementation of a quality improvement programme to support advance care planning in five hospitals across a health region.
BMJ Supportive & Palliative Care
, 5
(1)
pp. 91-94.
10.1136/bmjspcare-2013-000574.
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Abstract
OBJECTIVES: Advance care planning (ACP) can help patients with a terminal illness to prepare for the end of their lives. This report describes a regional service improvement initiative to increase the identification of hospital inpatients at this stage in their illnesses and to increase the number of such patients who are offered the opportunity to start the process of ACP. METHODS: Data were collected prospectively over a 7 month period from four acute hospital trusts and a specialist cancer centre in the South-West London region. Each unit identified a specific patient population who were screened for eligibility to engage in the process of ACP. Data concerning the reasons for eligibility, the suitability for discussion and the various reasons why patients did not complete the process, were recorded. RESULTS: Over a 7 month period 1980 patients were screened and 559 (28.2%) were found to be potentially eligible for an ACP discussion. Of these 227/559 (40.6%) were deemed suitable for a discussion by medical staff. The majority of these patients (195/227; 86%) were offered the opportunity to undergo ACP discussions and 144/195 (73.8%) agreed to begin the process of ACP. CONCLUSIONS: This report shows that a targeted approach can result in increased uptake in the number of patients who engage in ACP. However, systematic identification of potentially eligible patients requires a significant investment of clinical time and resources.
| Type: | Article |
|---|---|
| Title: | Implementation of a quality improvement programme to support advance care planning in five hospitals across a health region. |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjspcare-2013-000574 |
| Publisher version: | http://dx.doi.org/10.1136/bmjspcare-2013-000574 |
| Language: | English |
| Additional information: | This article has been accepted for publication in BMJ Supportive & Palliative Care following peer review. The definitive copyedited, typeset version Schofield, G; Kreeger, L; Meyer, M; Swann, D; Wijeratne, A; Wood, J; Stone, P; (2015) Implementation of a quality improvement programme to support advance care planning in five hospitals across a health region. BMJ Supportive & Palliative Care , 5 (1) pp. 91-94, is available online at: http://dx.doi.org/10.1136/bmjspcare-2013-000574. |
| Keywords: | Advance Care Planning, Discharge Planning, Service Evaluation, Advance Care Planning, Eligibility Determination, Health Plan Implementation, Hospitals, Humans, Inpatients, London, Program Evaluation, Prospective Studies, Quality Improvement |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1432756 |
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