G88(P) Advancing access to advance care plans

• Published in: Archives of disease in childhood 2020-10, Vol.105 (Suppl 1), p.A28-A29
• Main Authors: Norris, F, Shand, E, Hain, R, Griffiths, J
• Format: Article
• Language: English
• Subjects: Advance directives; Palliative care; Pediatrics; Quality control
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2020-rcpch.69

IntroductionThe Paediatric Advance Care Plan (PAC-Plan) supports families in exploring understanding of the multiagency response to death. This record of conversations helps support families and clinicians to make decisions during often fraught and difficult circumstances at the end of life. In practice its effectiveness is often restricted because in times of crisis it cannot be found.The aim of this quality improvement (QI) project was to improve access to PAC-Plans a) for out-of-hours medical staff in our local district general hospital, where such crises might occur, and b) by the Paediatric Palliative Care team from across the region.MethodSmall cycles of change included uploading updated plans to the local intranet portal, educating staff on how to find the plans using a ‘how to’ guide, education and posters placed around the wards. Effectiveness of the change was evaluated by time taken by medical staff to find a PAC-Plan using a hospital identification number.ResultsAfter 3 small cycles of change there was a fall of 83% in median time taken to access the PAC-Plan from 4 minutes 55 seconds to 50 seconds.ConclusionA significant reduction in time taken to find PAC-Plans using the existing intranet system was achieved through a combination of correctly uploading PAC-Plans, and training staff. Further work would be to ensure this system is sustained.By ensuring appropriate logins and access to the NHS portal, any member of the palliative care team will be able to securely access PAC-Plans from any location across the region.