scholarly journals Comparison of clinicians’ perceptions of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) before and during the COVID-19 pandemic

2022 ◽  
pp. 100206
Author(s):  
Michelle Hartanto ◽  
Risheka Suthantirakumar
Keyword(s):  
Emergency Care ◽  
Care And Treatment

scholarly journals 1541 Treating Patients with Respect: Assessing the Completion Rate of The ReSPECT Form for Patients Admitted to Hospital

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Noshirwani ◽  
T Schrire ◽  
O Allon
Keyword(s):  
Emergency Care ◽  
Completion Rate ◽  
Significant Deterioration ◽  
Number Of Factors ◽  
Improve Compliance ◽  
Period Data ◽  
Patient Turnover ◽  
Care And Treatment ◽  
New Strategies ◽  
Trainee Education

Abstract Aim To assess the current completion rate of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form, and to identify ways to improve the completion rate for all inpatients under our care. Method All notes of admitted patients were reviewed for a completed ReSPECT form over a two-week period. Data was collected on whether a form had been completed and its respective fields. This was repeated in three cycles, introducing interventions between each cycle – trainee education and reminders were sent through our WhatsApp messenger group between cycles 1 and 2, and posters implemented between cycles 2 and 3. Results For cycle 1, out of 40 patient notes, 9 (22.5%) had a completed ReSPECT form. This increased to 25 out of 57 patients (43.9%) for cycle 2. Cycle 3 found 1 out of 16 patients (6.7%) had a completed ReSPECT form. Conclusions Our data demonstrated a significant deterioration in our compliance as a department. This could be due to a number of factors ranging from the coronavirus pandemic and staff redeployment to increased workloads, higher patient turnover, and new staff. In any outcome, the poster has proven to be ineffective. Whilst we identified that reminders via electronic message appear to have had an improvement, this has shown to be temporary, and may not be effective in busier times. As such, this audit has revealed a significant need for departmental change and to develop new strategies to improve compliance.

scholarly journals General practitioners’ experiences of emergency care and treatment planning in England: a focus group study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Caroline J. Huxley ◽  
Karin Eli ◽  
Claire A. Hawkes ◽  
Gavin D. Perkins ◽  
Rob George ◽  
...  
Keyword(s):  
Primary Care ◽  
Focus Groups ◽  
End Of Life ◽  
General Practitioners ◽  
Emergency Care ◽  
Secondary Care ◽  
End Of Life Care ◽  
Hospital Setting ◽  
Life Care ◽  
Care And Treatment

Abstract Background Emergency Care and Treatment Plans are recommended for all primary care patients in the United Kingdom who are expected to experience deterioration of their health. The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) was developed to integrate resuscitation decisions with discussions about wider goals of care. It summarises treatment recommendations discussed and agreed between patients and their clinicians for a future emergency situation and was designed to meet the needs of different care settings. Our aim is to explore GPs’ experiences of using ReSPECT and how it transfers across the primary care and secondary care interface. Methods We conducted five focus groups with GPs in areas being served by hospitals in England that have implemented ReSPECT. Participants were asked about their experience of ReSPECT, how they initiate ReSPECT-type conversations, and their experiences of ReSPECT-type recommendations being communicated across primary and secondary care. Focus groups were transcribed and analysed using Thematic Analysis. Results GPs conceptualise ReSPECT as an end of life planning document, which is best completed in primary care. As an end of life care document, completing ReSPECT is an emotional process and conversations are shaped by what a ‘good death’ is thought to be. ReSPECT recommendations are not always communicated or transferable across care settings. A focus on the patient’s preferences around death, and GPs’ lack of specialist knowledge, could be a barrier to completion of ReSPECT that is transferable to acute settings. Conclusion Conceptualising ReSPECT as an end of life care document suggests a difference in how general practitioners understand ReSPECT from its designers. This impacts on the transferability of ReSPECT recommendations to the hospital setting.

Successful implementation of the ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) process in a large UK based NHS Trust

Resuscitation ◽  
2017 ◽  
Vol 118 ◽  
pp. e95-e96
Author(s):  
Michelle Davies ◽  
Keith Couper ◽  
Luke Jeyes ◽  
Paul Slater ◽  
John Speakman ◽  
...  
Keyword(s):  
Emergency Care ◽  
Treatment Process ◽  
Successful Implementation ◽  
Care And Treatment

scholarly journals Secondary care consultant clinicians’ experiences of conducting emergency care and treatment planning conversations in England: an interview-based analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e031633 ◽  
Author(s):  
Karin Eli ◽  
Cynthia Ochieng ◽  
Claire Hawkes ◽  
Gavin D Perkins ◽  
Keith Couper ◽  
...  
Keyword(s):  
Emergency Care ◽  
Secondary Care ◽  
Emotional Reactions ◽  
Ward Round ◽  
Structured Interviews ◽  
Short Term ◽  
Illness Trajectory ◽  
Care And Treatment ◽  
Treatment Escalation ◽  
Management Of Uncertainty

ObjectiveTo examine secondary care consultant clinicians’ experiences of conducting conversations about treatment escalation with patients and their relatives, using the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process.DesignSemi-structured interviews following ward round observations.SettingTwo National Health Service hospitals in England.ParticipantsFifteen medical and surgical consultants from 10 specialties, observed in 14 wards.AnalysisInterview transcripts were analysed using thematic analysis.ResultsThree themes were developed: (1) determining when and with whom to conduct a ReSPECT conversation; (2) framing the ReSPECT conversation to manage emotions and relationships and (3) reaching ReSPECT decisions. The results showed that when timing ReSPECT conversations, consultant clinicians rely on their predictions of a patient’s short-term prognosis; when framing ReSPECT conversations, consultant clinicians seek to minimise distress and maximise rapport and when involving a patient or a patient’s relatives in decision-making discussions, consultant clinicians are guided by their level of certainty about the patient’s illness trajectory.ConclusionsThe management of uncertainty about prognoses and about patients’ emotional reactions is central to secondary care consultant clinicians’ experiences of timing and conducting ReSPECT conversations.

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