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September 23-24, 2019 | Prague, Czech Republic
2nd International Conference on
Palliative Care
Clinical Trials and Pharmacovigilance
Joint Event
&
Advance care planning evaluation: A 3-fold plan for the future
Ros Johnstone
Betsi Cadwaladr University Health Board, UK
Advance care planning (ACP) is a patient driven discussion
about wishes and preferences for future care. Discussions
are documented in a patient held ACP document. An
ACP is of particular relevance if disease progression
impacts on capacity or capability of the patient to speak
for their self. Evaluating ACP as a complex intervention
requires a mixed method, multi-study approach assessing
impact on patients, those important to them, healthcare
professionals, service development and delivery. A three-
part evaluation was developed with two parallel
Aims: i) Toevaluate the impact of ACPeducationonpractice
and to inform the continued provision of ACP training. ii)
To understand the unanswered questions relating to ACP
and the research challenges these raise. Awareness of ACP
amongst the general public and healthcare professionals
is varied, to support the introduction of ACP discussion
opportunities a series of 24 half day ACP workshops were
provided, training 363 healthcare professionals from a
variety of clinical backgrounds and settings.
Results: Immediate feedback indicated understanding
(98%) skills (89%) and confidence (86%) were increased. Six
months later we evaluated the transfer of knowledge from
the classroom to the clinical setting. Utilizing ACP workshop
registers a 14 item electronic survey was distributed to
all workshop attendees. The response rate was 19% and
indicated that ACP understanding, skills and confidence
were increased. Transfer of ACP knowledge into practice
was positively indicated by 68% of respondents with barriers
identified as: “staff shortages,” “not enough time,” “not my
role to do this”. Exploration of the survey outcomes was done
by inviting survey respondents to participate in a focus group
session concerned with ACP. Twenty-two participants were
identified with 19 agreeing to attend a focus group.
Conclusion: Combined outcomes will support training
provision and inform development of future ACP evaluation
and research.
Speaker Biography
Ros Johnstone has managed a range of palliative care projects over the
past twenty years With a background in psychology and health psychology
and considerable post- graduate experience in health services research. As
project manager for the palliative care department (West) of BCUHB. She
managed the all-Wales project concerned with the care decisions for the
last days of life formerly Integrated Care Priorities (ICP) for the last days of
life and local North Wales projects. She has published widely and regularly
in peer reviewed journals on various aspects of the care decisions work and
advancecareplanningaswellasgivingpersonalandposterpresentationsat
national and international conferences. Local work has involved assessing
the outcomes of complementary therapy in palliative day care and
improving palliative care education in North Wales nursing homes through
the introduction of care decisions for the last days of life. Recently, she was
appointed as Macmillan BCUHB ACP Lead, an initiative promoting advance
care planning discussion opportunities for people across North Wales. She
holds an honorary lectureship at Bangor University and regularly gives
lectures on advance care planning to undergraduate nursing students.
Wider interests include developing research studies identifying the most
appropriate methodology for use in clinical trials involving dying patients.
e:
Journal of Primary Care and General Practice | Volume 2
J Prim Care Gen Pract, Volume:2