Advance Care Planning Gold Coast Medicare Local Aged Care Forum June 2014

Transcription

1 Advance Care Planning Gold Coast Medicare Local Aged Care Forum June 2014

2 Advance care planning: Advance care planning is the process through which people make decisions about their future care in the event of them losing their decision making capacity. It is done in consultation with clinicians, family members and significant others It primarily involves having discussions about future care choices and wishes

3 Advance care planning provides a mechanism to improve the quality of end of life care for people. It enables the coordination of their desired access to resources and services, to match their anticipated care needs. Advance care planning offers everyone, and especially people living with a terminal condition, their families and significant others the opportunity to take control of decisions which affect their care.

4 Advance care planning is a process, not a task

5 Benefits of advance care planning: Patient & Family Patient centred care Improves patient and family satisfaction Reduced stress anxiety and depression in surviving relatives Health professional Patient centred care Assists with end of life care planning and treatment options Organisation and System Reduced hospitalisations Reduced financial burden on acute care facilities Quality Improvement Payment

6 Advance care plans are tools in the advance care planning process: Acute Resuscitation Plan Advance Care Plan Advance Health Directive

7 Legislation governing end of life decision making in Queensland: Powers of Attorney Act 1998 (Qld) Guardianship and Administration Act 2000

8 Decision-making hierarchy in Queensland: Substitute decision-makers IN ORDER 1. The patient s valid Advance Health Directive 2. QCAT-appointed Guardian 3. Enduring Power of Attorney 4. Statutory Health Attorney 5. The Public Guardian

9 Advance Care Planning Trial Gold Coast Hospital and Health Service July October 2014

10 Background to the trial: In May 2013 the Queensland Clinical Senate (QCS) met and agreed that Advance Care Planning is a clinical priority for Queensland health facilities. QCS made recommendations to the Health Minister

11 QCS Recommendations: 1. All people entering residential aged care (or substitute decision makers) should be given the option to complete an Advance Care Plan prior to admission to a RACF. 2. The ACP: must be reflective of the individuals wishes Should ideally be completed prior to but definitely within 2 weeks of admission needs to be supported by standardised documentation needs to be readily accessible to health practitioners

12 QCS Recommendations: 3. The Minister, through the Department, lobby the Commonwealth: To ensure appropriate remuneration through the Medicare Benefits Scheme (MBS) for primary care clinicians to complete ACPs For modification of the Residential Aged Care standard related to palliative care to mandate that residents be given the option to complete an ACP within 2 weeks of admission to facility For a national community awareness campaign

13 QCS Recommendations: 4. Hospital and Health Services and Medicare Locals: Support the introduction of standardised statewide ACP documentation as recommended by the QCS and provide training to clinicians around the completion of ACPs Mandate that all hospital patients on a residential placement pathway be given the option to complete an ACP before transfer to the facility

14 Does the patient meet the criteria for advance care planning? Yes No Does the patient have capacity to have an ACP discussion? Introduce ACP and leave information brochure with patient / SDM Yes No Contact SDM No further action required Follow up: does the patient / SDM consent to an ACP discussion? Arrange ACP discussion meeting with family / SDM Have ACP discussion meeting Complete ACP form Yes No Document decision in medical record COMPLETE TRACKING FORM File and share form COMPLETE TRACKING FORM

15 Advance Care Plan No legally binding decisions choices NOT decisions Documents end of life wishes and preferences of patient Part A Patient s health care wishes Part B Record for Health Professionals

16 ACP Trial Resources: ACP Brochure: ACP Booklet:

17 Key messages: Advance care planning is a process, not a task Advance care planning benefits the patient, their family, their health care professionals and the health system Advance care planning can occur over a number of days and discussions The advance care planning trial is underway at this facility until October 2014

18 Thank you for listening! Any questions?