Advance-care-planning (ACP) documentation strategies; Goals-of-Care (GOC) as an alternative to Not-for-Resuscitation (NFR) in #medical and #oncology patients. A pre-and-post controlled study on quantifiable outcomes

Abstract

BACKGROUND: Health services in #Tasmania, #Victoria and now Western #Australia are changing to goals-of-care (GOC) advance-care-planning (ACP) documentation strategies.

AIM: To compare the #clinicalimpact of two different health department sanctioned ACP documentation strategies.

METHODS: An unblinded, pre-and-post, controlled study over two corresponding six-month periods in 2016 and 2017 comparing the current discretional not-for-resuscitation (NFR) with a new, inclusive GOC strategy in two medical/#oncology wards at a large private hospital. Main outcomes were the uptake of ACP forms per #hospitalisation and the timing between hospital admission, ACP form completion, and in-patient death. Secondary outcomes included utilisation of the rapid response team (RRT), #palliative and critical care services