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OP35 A national framework for anticipation in health care: the swiss proposal
  1. S Eychmueller1,
  2. S Felber1 and
  3. T Krones2
  1. 1University of Bern, Bern, Switzerland
  2. 2University of Zurich, Zurich, Switzerland


Background Anticipatory planning including advance care planning has become one of the megatrends in health care. As in many countries, terminology and understanding of anticipatory planning varies significantly.

Aim For a common understanding of anticipation and guidance in clinical practice, we aimed to develop a national framework for anticipation in health care in Switzerland.

Method we undertook a national consensus project with representatives from all cultural regions in Switzerland. After review of the literature and existing guidelines and/or recommendations we performed a three Delphi process including additional national expert review.

Results We propose a three level model of anticipatory planning in health care. Level one aims to initiate general anticipatory planning including discussion on individual values, preferences and expectations; experts from various professional background (e.g. pastoral care, social care, psychology) may offer support on this level. Level two focuses on disease specific anticipatory care planning; expertise in regard of potential complication of specific diagnosis/disease trajectory is necessary to provide assistance while planning. Level three finally is dedicated to advance care planning (ACP) for clinical situations without capacity for judgement; guidance by professionals with a background in intensive and emergency care may be needed.

Conclusions a national consensus process on definitions of various levels for a participatory approach in anticipatory planning helps to create a solid basis for common understanding of anticipation in health care, to highlight professional roles and expertise for counselling on each level, and to prevent low quality in written documentation.

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