Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs
Abstract Background Advance Care Planning (ACP) and its documentation, accessible to healthcare professionals regardless of where patients are staying, can improve palliative care. ACP is usually performed by trained facilitators. However, ACP conversations would be more tailored to a patient’s spec...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-05-01
|
| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12904-018-0331-3 |
| _version_ | 1819060129102823424 |
|---|---|
| author | Maaike Kok Gertruud F. M. van der Werff Jenske I. Geerling Jaap Ruivenkamp Wies Groothoff Annette W. G. van der Velden Monique Thoma Jaap Talsma Louk G. P. Costongs Reinold O. B. Gans Pauline de Graeff Anna K. L. Reyners |
| author_facet | Maaike Kok Gertruud F. M. van der Werff Jenske I. Geerling Jaap Ruivenkamp Wies Groothoff Annette W. G. van der Velden Monique Thoma Jaap Talsma Louk G. P. Costongs Reinold O. B. Gans Pauline de Graeff Anna K. L. Reyners |
| author_sort | Maaike Kok |
| collection | DOAJ |
| description | Abstract Background Advance Care Planning (ACP) and its documentation, accessible to healthcare professionals regardless of where patients are staying, can improve palliative care. ACP is usually performed by trained facilitators. However, ACP conversations would be more tailored to a patient’s specific situation if held by a patient’s clinical healthcare team. This study assesses the feasibility of ACP by a patient’s clinical healthcare team, and analyses the documented information including current and future problems within the palliative care domains. Methods This multicentre study was conducted at the three Groningen Palliative Care Network hospitals in the Netherlands. Patients discharged from hospital with a terminal care indication received an ACP document from clinical staff (non-palliative care trained staff at hospitals I and II; specialist palliative care nurses at hospital III) after they had held ACP conversations. An anonymised copy of this ACP document was analysed. Documentation rates of patient and contact details were investigated, and documentation of current and future problems were analysed both quantitatively and qualitatively. Results One hundred sixty ACP documents were received between April 2013 and December 2014, with numbers increasing for each consecutive 3-month time period. Advance directives were frequently documented (82%). Documentation rates of current problems in the social (24%), psychological (27%) and spiritual (16%) domains were low compared to physical problems (85%) at hospital I and II, but consistently high (> 85%) at hospital III. Of 545 documented anticipated problems, 92% were physical or care related in nature, 2% social, 5% psychological, and < 1% spiritual. Half of the anticipated non-physical problems originated from hospital III. Conclusions Hospital-initiated ACP documentation by a patient’s clinical healthcare team is feasible: the number of documents received per time period increased throughout the study period, and overall, documentation rates were high. Nonetheless, symptom documentation predominantly regards physical symptoms. With the involvement of specialist palliative care nurses, psychological and spiritual problems are addressed more frequently. Whether palliative care education for non-palliative care experts will improve identification and documentation of non-physical problems remains to be investigated. |
| first_indexed | 2024-12-21T14:22:05Z |
| format | Article |
| id | doaj.art-7f91f78c5c5c4debbca3e670238bb269 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-12-21T14:22:05Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-7f91f78c5c5c4debbca3e670238bb2692022-12-21T19:00:45ZengBMCBMC Palliative Care1472-684X2018-05-011711810.1186/s12904-018-0331-3Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needsMaaike Kok0Gertruud F. M. van der Werff1Jenske I. Geerling2Jaap Ruivenkamp3Wies Groothoff4Annette W. G. van der Velden5Monique Thoma6Jaap Talsma7Louk G. P. Costongs8Reinold O. B. Gans9Pauline de Graeff10Anna K. L. Reyners11Department of Medical Oncology, University of Groningen, University Medical Center GroningenMartini Hospital, Palliative Care TeamDepartment of Medical Oncology, University of Groningen, University Medical Center GroningenOmmelander Ziekenhuis Groningen, Palliative Care TeamOmmelander Ziekenhuis Groningen, Palliative Care TeamDepartment of Medical Oncology, University of Groningen, University Medical Center GroningenTSN Care GroningenAcademic General Practice, University of Groningen, University Medical Center GroningenZonnehuisgroep NoordDepartment of Internal Medicine, University of Groningen, University Medical Center GroningenUniversity of Groningen, University Medical Center Groningen, Department of Internal Medicine, University Center of Geriatric MedicineDepartment of Medical Oncology, University of Groningen, University Medical Center GroningenAbstract Background Advance Care Planning (ACP) and its documentation, accessible to healthcare professionals regardless of where patients are staying, can improve palliative care. ACP is usually performed by trained facilitators. However, ACP conversations would be more tailored to a patient’s specific situation if held by a patient’s clinical healthcare team. This study assesses the feasibility of ACP by a patient’s clinical healthcare team, and analyses the documented information including current and future problems within the palliative care domains. Methods This multicentre study was conducted at the three Groningen Palliative Care Network hospitals in the Netherlands. Patients discharged from hospital with a terminal care indication received an ACP document from clinical staff (non-palliative care trained staff at hospitals I and II; specialist palliative care nurses at hospital III) after they had held ACP conversations. An anonymised copy of this ACP document was analysed. Documentation rates of patient and contact details were investigated, and documentation of current and future problems were analysed both quantitatively and qualitatively. Results One hundred sixty ACP documents were received between April 2013 and December 2014, with numbers increasing for each consecutive 3-month time period. Advance directives were frequently documented (82%). Documentation rates of current problems in the social (24%), psychological (27%) and spiritual (16%) domains were low compared to physical problems (85%) at hospital I and II, but consistently high (> 85%) at hospital III. Of 545 documented anticipated problems, 92% were physical or care related in nature, 2% social, 5% psychological, and < 1% spiritual. Half of the anticipated non-physical problems originated from hospital III. Conclusions Hospital-initiated ACP documentation by a patient’s clinical healthcare team is feasible: the number of documents received per time period increased throughout the study period, and overall, documentation rates were high. Nonetheless, symptom documentation predominantly regards physical symptoms. With the involvement of specialist palliative care nurses, psychological and spiritual problems are addressed more frequently. Whether palliative care education for non-palliative care experts will improve identification and documentation of non-physical problems remains to be investigated.http://link.springer.com/article/10.1186/s12904-018-0331-3Advance care planning [MeSH]Advance directive [MeSH]End-of-life care [MeSH]Palliative care [MeSH]Patient preferenceCohort studies |
| spellingShingle | Maaike Kok Gertruud F. M. van der Werff Jenske I. Geerling Jaap Ruivenkamp Wies Groothoff Annette W. G. van der Velden Monique Thoma Jaap Talsma Louk G. P. Costongs Reinold O. B. Gans Pauline de Graeff Anna K. L. Reyners Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs BMC Palliative Care Advance care planning [MeSH] Advance directive [MeSH] End-of-life care [MeSH] Palliative care [MeSH] Patient preference Cohort studies |
| title | Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs |
| title_full | Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs |
| title_fullStr | Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs |
| title_full_unstemmed | Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs |
| title_short | Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs |
| title_sort | feasibility of hospital initiated non facilitator assisted advance care planning documentation for patients with palliative care needs |
| topic | Advance care planning [MeSH] Advance directive [MeSH] End-of-life care [MeSH] Palliative care [MeSH] Patient preference Cohort studies |
| url | http://link.springer.com/article/10.1186/s12904-018-0331-3 |
| work_keys_str_mv | AT maaikekok feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT gertruudfmvanderwerff feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT jenskeigeerling feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT jaapruivenkamp feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT wiesgroothoff feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT annettewgvandervelden feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT moniquethoma feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT jaaptalsma feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT loukgpcostongs feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT reinoldobgans feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT paulinedegraeff feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds AT annaklreyners feasibilityofhospitalinitiatednonfacilitatorassistedadvancecareplanningdocumentationforpatientswithpalliativecareneeds |