Background There are many barriers to advance care planning in paediatrics. High expectations for cure, difficulties prognosticating and a lack of training in how to approach thèse conversations mean that care planning often occurs late or not at all. Further, many of the advance care planning documents developed to date focus on interventions rather than goals of care. This can drive ‘tick box’ discussions which both paediatricians and parents find confronting.
Aim To create a suite of resources to assist paediatricians and families to engage in discussions regarding goals of care as a means of facilitating advance care planning.
Methods Literature review, consultation with paediatricians and families, and an audit of patient deaths to identify potential triggers for advance care planning.
Results Development of;
A Goals of Patient Care Document consisting of six components, all accessible via an electronic medical record and able to capture evolving discussions and decisions,
A discussion guide for paediatricians outlining key principles and suggested phrases,
An on-line education module for health professionals,
A set of triggers for advance care planning,
A written resource for parents.
Discussion/conclusion Advance care planning requires the development of tools to capture both decisions made and discussions in progress. Paediatricians need assistance to identify when advance care planning is needed and suggested ways of approaching the discussion. Audit and research is now required to determine the efficacy of this newly developed suite of resources.
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