Development of the Recommended Summary Plan for eEmergency Care and Treatment (ReSPECT)
Development of the Recommended Summary Plan for eEmergency Care and Treatment (ReSPECT)
Introduction: Do-not-attempt-cardiopulmonary-resuscitation (DNACPR) practice has been shown to be variable and sub-optimal. This paper describes the development of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT). ReSPECT is a process which encourages shared understanding of a patient’s condition and what outcomes they value and fear, before recording clinical recommendations about cardiopulmonary-resuscitation (CPR) within a broader plan for emergency care and treatment.
Methods: ReSPECT was developed iteratively, with integral stakeholder engagement, informed by the Knowledge-to-Action cycle. Mixed methods included: synthesis of existing literature; a national online consultation exercise; cognitive interviews with users; a patient-public involvement (PPI) workshop and a usability pilot, to ensure acceptability by both patients and professionals.
Results: the majority (89%) of consultation respondents supported the concept of emergency care and treatment plans. Key features identified in the evaluation and incorporated into ReSPECT were: The importance of discussions between patient and clinician to inform realistic treatment preferences and clarity in the resulting recommendations recorded by the clinician on the form. The process is compliant with UK mental capacity laws. Documentation should be recognised across all health and care settings. There should be opportunity for timely review based on individual need.
Conclusion: ReSPECT is designed to facilitate discussions about a person’s preferences to inform emergency care and treatment plans (including CPR) for use across all health and care settings. It has been developed iteratively with a range of stakeholders. Further research will be needed to assess the influence of ReSPECT on patient-centred decisions, experience and health outcomes.
Adults, DNACPR, Emergency care and treatment plans, Paediatrics, ReSPECT, Recommended Summary Plan for Emergency Care and Treatment, Treatment escalation plans
98-107
Hawkes, Claire A
be928599-871f-4a24-b5aa-88c6be2cb1d3
Fritz, Zoe
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Deas, Gavin
1f0317e9-bf66-4e02-9a29-9fc66e9c5466
Ahmedzai, Sam H
93ab9187-5d4c-4f5a-b673-51567de1186c
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Pitcher, David
5eb7b7da-7eb1-4713-a893-0ab7b210d042
Spiller, Juliet
2e70a654-e719-4ddb-848a-c430f6e3c2b5
Perkins, Gavin D
62ab34e9-3022-4b9d-a64b-99a13fbe45a3
1 March 2020
Hawkes, Claire A
be928599-871f-4a24-b5aa-88c6be2cb1d3
Fritz, Zoe
934e7923-27bf-4add-afae-d352e8e09d01
Deas, Gavin
1f0317e9-bf66-4e02-9a29-9fc66e9c5466
Ahmedzai, Sam H
93ab9187-5d4c-4f5a-b673-51567de1186c
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Pitcher, David
5eb7b7da-7eb1-4713-a893-0ab7b210d042
Spiller, Juliet
2e70a654-e719-4ddb-848a-c430f6e3c2b5
Perkins, Gavin D
62ab34e9-3022-4b9d-a64b-99a13fbe45a3
Hawkes, Claire A, Fritz, Zoe, Deas, Gavin, Ahmedzai, Sam H, Richardson, Alison, Pitcher, David, Spiller, Juliet and Perkins, Gavin D
(2020)
Development of the Recommended Summary Plan for eEmergency Care and Treatment (ReSPECT).
Resuscitation, 148, .
(doi:10.1016/j.resuscitation.2020.01.003).
Abstract
Introduction: Do-not-attempt-cardiopulmonary-resuscitation (DNACPR) practice has been shown to be variable and sub-optimal. This paper describes the development of the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT). ReSPECT is a process which encourages shared understanding of a patient’s condition and what outcomes they value and fear, before recording clinical recommendations about cardiopulmonary-resuscitation (CPR) within a broader plan for emergency care and treatment.
Methods: ReSPECT was developed iteratively, with integral stakeholder engagement, informed by the Knowledge-to-Action cycle. Mixed methods included: synthesis of existing literature; a national online consultation exercise; cognitive interviews with users; a patient-public involvement (PPI) workshop and a usability pilot, to ensure acceptability by both patients and professionals.
Results: the majority (89%) of consultation respondents supported the concept of emergency care and treatment plans. Key features identified in the evaluation and incorporated into ReSPECT were: The importance of discussions between patient and clinician to inform realistic treatment preferences and clarity in the resulting recommendations recorded by the clinician on the form. The process is compliant with UK mental capacity laws. Documentation should be recognised across all health and care settings. There should be opportunity for timely review based on individual need.
Conclusion: ReSPECT is designed to facilitate discussions about a person’s preferences to inform emergency care and treatment plans (including CPR) for use across all health and care settings. It has been developed iteratively with a range of stakeholders. Further research will be needed to assess the influence of ReSPECT on patient-centred decisions, experience and health outcomes.
Text
Development of the Recommended Summary Plan for Emergency Care and Treatment [accepted manuscript]
- Accepted Manuscript
Text
Development of the Recommended Summary Plan for Emergency Care and Treatment [tables and figures]
- Other
More information
Accepted/In Press date: 2 January 2020
e-pub ahead of print date: 13 January 2020
Published date: 1 March 2020
Additional Information:
Funding Information:
Gavin Perkins’ and Claire Hawkes’ employer, the University of Warwick, received funding from the Resuscitation Council (UK) to conduct the evaluation. Professors Richardson and Perkins are National Institute for Health Research (NIHR) Senior Investigators. Professor Perkins is an Editor of Resuscitation. All authors contributed to the development of ReSPECT.
Funding Information:
The development of ReSPECT was funded by the Resuscitation Council UK, with some contribution from the Royal College of Nursing. AR’s contribution to the evaluation was facilitated through funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex. Funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The views expressed in this article are those of the author(s) and not necessarily those of the Resuscitation Council UK, the Royal College of Nursing, the NHS, the NIHR, or the Department of Health.
Publisher Copyright:
© 2020 Elsevier B.V.
Keywords:
Adults, DNACPR, Emergency care and treatment plans, Paediatrics, ReSPECT, Recommended Summary Plan for Emergency Care and Treatment, Treatment escalation plans
Identifiers
Local EPrints ID: 436939
URI: http://eprints.soton.ac.uk/id/eprint/436939
ISSN: 0300-9572
PURE UUID: 27f9e2d8-3507-4395-adcb-67409158b3d0
Catalogue record
Date deposited: 14 Jan 2020 17:31
Last modified: 17 Mar 2024 05:13
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Contributors
Author:
Claire A Hawkes
Author:
Zoe Fritz
Author:
Gavin Deas
Author:
Sam H Ahmedzai
Author:
David Pitcher
Author:
Juliet Spiller
Author:
Gavin D Perkins
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