Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making

BACKGROUND: Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support...

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Main Authors: Waldron, N., Johnson, C., Saul, P., Waldron, H., Chong, J., Hill, Anne-Marie, Hayes, B.
Format: Journal Article
Published: BioMed Central 2016
Online Access:http://hdl.handle.net/20.500.11937/57970
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author Waldron, N.
Johnson, C.
Saul, P.
Waldron, H.
Chong, J.
Hill, Anne-Marie
Hayes, B.
author_facet Waldron, N.
Johnson, C.
Saul, P.
Waldron, H.
Chong, J.
Hill, Anne-Marie
Hayes, B.
author_sort Waldron, N.
building Curtin Institutional Repository
collection Online Access
description BACKGROUND: Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support clinicians to undertake and document routine advance care planning discussions. METHODS: Two focus groups, which involved eight consultants and ten junior doctors, were conducted following a review of the current literature. A subsequent iterative consensus process developed two intervention elements: (i) an updated 'Goals of Patient Care' (GOPC) form and process; (ii) an education video and resources for teaching advance CPR decision-making and communication. A multidisciplinary group of health professionals and policy-makers with experience in systems development, education and research provided critical feedback. RESULTS: Three key themes emerged from the focus groups and the literature, which identified a structure for the intervention: (i) knowing what to say; (ii) knowing how to say it; (iii) wanting to say it. The themes informed the development of a video to provide education about advance CPR decision-making framework, improving communication and contextualising relevant clinical issues. Critical feedback assisted in refining the video and further guided development and evolution of a medical GOPC approach to discussing and recording medical treatment and advance care plans. CONCLUSION: Through an iterative process of consultation and review, video-based education and an expanded GOPC form and approach were developed to address physician and systemic barriers to advance CPR decision-making and documentation. Implementation and evaluation across hospital settings is required to examine utility and determine effect on quality of care.
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spelling curtin-20.500.11937-579702018-01-12T03:41:01Z Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making Waldron, N. Johnson, C. Saul, P. Waldron, H. Chong, J. Hill, Anne-Marie Hayes, B. BACKGROUND: Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support clinicians to undertake and document routine advance care planning discussions. METHODS: Two focus groups, which involved eight consultants and ten junior doctors, were conducted following a review of the current literature. A subsequent iterative consensus process developed two intervention elements: (i) an updated 'Goals of Patient Care' (GOPC) form and process; (ii) an education video and resources for teaching advance CPR decision-making and communication. A multidisciplinary group of health professionals and policy-makers with experience in systems development, education and research provided critical feedback. RESULTS: Three key themes emerged from the focus groups and the literature, which identified a structure for the intervention: (i) knowing what to say; (ii) knowing how to say it; (iii) wanting to say it. The themes informed the development of a video to provide education about advance CPR decision-making framework, improving communication and contextualising relevant clinical issues. Critical feedback assisted in refining the video and further guided development and evolution of a medical GOPC approach to discussing and recording medical treatment and advance care plans. CONCLUSION: Through an iterative process of consultation and review, video-based education and an expanded GOPC form and approach were developed to address physician and systemic barriers to advance CPR decision-making and documentation. Implementation and evaluation across hospital settings is required to examine utility and determine effect on quality of care. 2016 Journal Article http://hdl.handle.net/20.500.11937/57970 10.1186/s12913-016-1803-x http://creativecommons.org/licenses/by/4.0/ BioMed Central fulltext
spellingShingle Waldron, N.
Johnson, C.
Saul, P.
Waldron, H.
Chong, J.
Hill, Anne-Marie
Hayes, B.
Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making
title Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making
title_full Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making
title_fullStr Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making
title_full_unstemmed Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making
title_short Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making
title_sort development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making
url http://hdl.handle.net/20.500.11937/57970