Background Lack of time is a recognised barrier to Advance Care Planning (ACP). ACP is a conversation that allows the person to specify preferences in relation to end of life care, stating wishes and choices.
Rowcroft Hospice with funding from Health Education England worked with people from different care settings to develop a brief intervention in ACP with the aim of opening-up conversations with patients, giving staff prompts to help guide them.
Method Through a Macmillan funded project, we tested the Advance Care Planning Brief Intervention (ACP-BI) in practice for:
Usability by health care professionals (HCPs)
Acceptability by patients as reported by HCPs
To refine the training programme and BI, based on staff feedback
A steering group provided direction to the project. 24 HCPs were recruited from Nursing homes, Acute hospital, Community Hospitals and Community Nursing teams. A self-assessment tool was developed for the HCPs to test the intervention. Bespoke training was delivered and evaluated. Data on staff learning, including a reflective piece, were collected via a learning management system. Focus groups with HCPs were held midway and at the end of the project.
Results Not every person will engage with these conversations, HCPs included. However, the use of an ACP-BI, with training, and mentorship gives HCPs a building block to broach conversations about future planning, focusing on the patient‘s future and wishes. Qualitative feedback from nurses suggests it is possible to use a brief intervention for ACP: ‘The initial conversation was only 15 minutes. I am surprised at how short these very important conversations can be’.
Conclusion Given that the median time of the 47 conversations was 12.5 minutes, time can no longer be used as a barrier to these conversations. We recommend the ACP-BI is further tested through research.
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