Planting the seed: introducing advance care planning information sessions into a pulmonary rehabilitation programme– A collaborative project

Abstract

Background: International Guidelines recommend Pulmonary Rehabilitation Programmes (PRP) as ideal settings for advance care planning (ACP). Despite ten years of experience delivering PRP, health care professionals (HCP) at our centre failed to include ACP sessions into the education programme citing the absence of helpful implementation models. Aim: This collaborative project aimed to introduce ACP information sessions into the PRP by meeting patient9s needs and upskilling HCP in delivering the sessions. Methods: Following literature review, Palliative Care clinicians were consulted and observed delivering ACP sessions. Respiratory Nurses9 expertise of ACP with individual patients, staff education and consultation with patients/relatives were utilised. Patients expertise living with a life limiting condition and their concerns shaped session content and delivery. Patients9, relatives9 and HCP perceptions and reflections were reviewed at each step of the process, guiding the successful implementation. Results: 52 patients and 5 relatives attended 4 ACP sessions between May and November 2014. Qualitative feedback indicates the majority of patients/relatives welcome ACP, signifying their readiness for the topic. Respiratory Nurses providing sessions gained confidence and competence in delivering the material. Sessions follow a structured standardised programme introducing ACP within the PRP. Conclusion: Our experience to date is that patients and relatives are ready for ACP information. Sessions plant the seed for proactive end of life care planning over time. This collaborative project opened a dialogue and fostered meaningful patient - HCP partnership.