P-53 Review, refresh, relaunch: scoping of anticipatory clinical management planning and decisions about cardio pulmonary resuscitation

Abstract

<h3>Background</h3> The need for a consistent approach to Advance Care Planning (ACP) was highlighted in the CQC Report: Protect, Respect, Connect. Regional guidelines outline a consistent approach to Anticipatory Clinical Management Planning (ACMP), including decisions about cardiopulmonary resuscitation (CPR), but it was not known how widely these guidelines were implemented. <h3>Methods</h3> A scoping survey was undertaken across 5 Integrated Care Partnerships (ICPs) within an Integrated Care System (ICS) to provide a high level overview of principles of practice regarding decision-making, documentation, education and governance of ACMPS. <h3>Key findings</h3> The ACMP guidelines are followed across the ICS, with their use predominantly driven by palliative and end-of-life networks. A consistent approach to resuscitation decisions is in place across the ICS. Approaches to other elements of anticipatory clinical management planning varies but each ICP has some processes in place (e.g. Anticipatory Clinical Management Plans, AMBER care bundle). The ability to share information between organisations manner remains a challenge. A regional education program supports education and training on future care planning, but this does not address the clinician-led elements of advance care planning. Individual provider organisations have some systems for oversight and assurance. <h3>Conclusions</h3> Regional ACMP guidelines inform a consistent approach to Advance Care Planning and have supported the implementation of a common approach to resuscitation decisions. It is recognised that a ‘consistent approach’ does not mean ‘all organisations and specialties using the same form’ and there is a need for ongoing collaboration across across primary, secondary and social care in order to develop system-wide processes which support shared decision making and patient centered care. An action plan includes refreshing current guidance and agreeing insight metrics and an education and training framework to promote and support effective advance care planning.