1291 DO PATIENTS UNDERSTAND THEIR RESPECT FORMS? A QI PROJECT REVIEWING PHRASES USED AND WHETHER THEY ARE MEANINGFUL TO PATIENTS. (16th January 2023)

• Record Type: Journal Article
• Authors: Mills, H; O'Sullivan, A; McCracken, S; El Mabruk, M
• Is Part Of: Age and ageing. Volume 52(2023)Supplement 1
• Publication Date: 2023-01-16
• Subjects: Aging -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1093/ageing/afac322.100
• Languages: English
• ISSNs: 0002-0729

Abstract

Abstract: Background: Hospital based Quality Improvement Project focusing on adapting language used on Recommended Summary Plan for Emergency Treatment and Care (ReSPECT) forms to improve patient understanding. Introduction: ReSPECT forms have been used to document patient wishes and appropriate escalation of treatment in our hospital since 2019. There continues to be a lack of understanding of phrases used amongst both patients and healthcare professionals; the hospital receives regular complaints. This project explored patients' perceptions of language used and their thoughts on the ReSPECT discussion, to better guide discussions and documentation. Methods: A questionnaire collecting qualitative and quantitative data was performed with 24 patients aged between 59-95 years old with ReSPECT forms on a medical ward (Geriatrics/ Endocrine). Results: The phrases 'DNACPR' and 'Not for ITU' were understood by 5/24 patients (21%), 'Ward based ceiling of care' was understood by only 1/24 (4%) and 'prioritising comfort care' understood by 8/24 patients (34%). Only 6/24 (25%) of patients said they were a 'little upset' by their admission conversation about ReSPECT and no patients surveyed were 'very upset'. Conclusions: This first QI cycle found that overall, most patients did not understand the language commonly used on ReSPECT forms, particularly 'ward-based ceiling of care'. The majority were not upset by the ReSPECT conversation, so a fear of upsetting the patient should not be a barrier to having a clear discussion. The next step in our QI work will be to explore phrases that are better understood by patients and then feedback findings so that we can develop a digital ReSPECT form with drop down options for phrases better understood by patients to describe ceilings of care.