Journal of Primary Care and General Practice

Advance care planning evaluation: A 3-fold plan for the future

2^nd International Conference on Palliative Care
September 23-24, 2019 | Prague, Czech Republic

Ros Johnstone

Betsi Cadwaladr University Health Board, UK

Scientific Tracks Abstracts : J Prim Care Gen Pract

Abstract:

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 threepart evaluation was developed with two parallel

Aims: i) To evaluate the impact of ACP education on practice 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.

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
advance care planning as well as giving personal and poster presentations at
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-mail: Rosalynde.Johnstone@wales.nhs.uk

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