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Current advance care planning practice in the Australian community: an online survey of home care package case managers and service managers.
BMC Palliat Care. 2015 Apr 23; 14:15.BP

Abstract

BACKGROUND

Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person's values, beliefs and treatment preferences are made known to guide clinical decision-making at a future time when they cannot communicate their decisions. Despite the potential benefits of ACP for community aged care clients the availability of ACP is unknown, but likely to be low. In Australia many of these clients receive services through Home Care Package (HCP) programs. This study aimed to explore current attitudes, knowledge and practice of advance care planning among HCP service managers and case managers.

METHODS

An invitation to take part in a cross-sectional online survey was distributed by email to all HCP services across Australia in November 2012. Descriptive analyses were used to examine overall patterns of responses to each survey item in the full sample.

RESULTS

120 (response rate 25%) service managers and 178 (response rate 18%) case managers completed the survey. Only 34% of services had written ACP policies and procedures in place and 48% of case managers had previously completed any ACP training. In addition, although most case managers (70%) had initiated an ACP discussion in the past 12 months and viewed ACP as part of their role, the majority of the conversations (80%) did not result in documentation of the client's wishes and most (85%) of the case managers who responded did not believe ACP was done well within their service.

CONCLUSIONS

This survey shows low organisational ACP systems and support for case managers and a lack of a normative approach to ACP across Australian HCP services. As HCPs become more prevalent it is essential that a model of ACP is developed and evaluated in this setting, so that clients have the opportunity to discuss and document their future healthcare wishes if they choose to.

Authors+Show Affiliations

Respecting Patient Choices, Austin Health, Melbourne, Australia. marcus.sellars@austin.org.au. Respecting Patient Choices Program, Austin Hospital, PO Box 5555, Heidelberg, Melbourne, VIC, 3084, Australia. marcus.sellars@austin.org.au.Respecting Patient Choices, Austin Health, Melbourne, Australia. karen.detering@austin.org.au.Respecting Patient Choices, Austin Health, Melbourne, Australia. william.silvester@austin.org.au.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25903912

Citation

Sellars, Marcus, et al. "Current Advance Care Planning Practice in the Australian Community: an Online Survey of Home Care Package Case Managers and Service Managers." BMC Palliative Care, vol. 14, 2015, p. 15.
Sellars M, Detering KM, Silvester W. Current advance care planning practice in the Australian community: an online survey of home care package case managers and service managers. BMC Palliat Care. 2015;14:15.
Sellars, M., Detering, K. M., & Silvester, W. (2015). Current advance care planning practice in the Australian community: an online survey of home care package case managers and service managers. BMC Palliative Care, 14, 15. https://doi.org/10.1186/s12904-015-0018-y
Sellars M, Detering KM, Silvester W. Current Advance Care Planning Practice in the Australian Community: an Online Survey of Home Care Package Case Managers and Service Managers. BMC Palliat Care. 2015 Apr 23;14:15. PubMed PMID: 25903912.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current advance care planning practice in the Australian community: an online survey of home care package case managers and service managers. AU - Sellars,Marcus, AU - Detering,Karen M, AU - Silvester,William, Y1 - 2015/04/23/ PY - 2014/09/05/received PY - 2015/04/15/accepted PY - 2015/4/24/entrez PY - 2015/4/24/pubmed PY - 2016/1/14/medline SP - 15 EP - 15 JF - BMC palliative care JO - BMC Palliat Care VL - 14 N2 - BACKGROUND: Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person's values, beliefs and treatment preferences are made known to guide clinical decision-making at a future time when they cannot communicate their decisions. Despite the potential benefits of ACP for community aged care clients the availability of ACP is unknown, but likely to be low. In Australia many of these clients receive services through Home Care Package (HCP) programs. This study aimed to explore current attitudes, knowledge and practice of advance care planning among HCP service managers and case managers. METHODS: An invitation to take part in a cross-sectional online survey was distributed by email to all HCP services across Australia in November 2012. Descriptive analyses were used to examine overall patterns of responses to each survey item in the full sample. RESULTS: 120 (response rate 25%) service managers and 178 (response rate 18%) case managers completed the survey. Only 34% of services had written ACP policies and procedures in place and 48% of case managers had previously completed any ACP training. In addition, although most case managers (70%) had initiated an ACP discussion in the past 12 months and viewed ACP as part of their role, the majority of the conversations (80%) did not result in documentation of the client's wishes and most (85%) of the case managers who responded did not believe ACP was done well within their service. CONCLUSIONS: This survey shows low organisational ACP systems and support for case managers and a lack of a normative approach to ACP across Australian HCP services. As HCPs become more prevalent it is essential that a model of ACP is developed and evaluated in this setting, so that clients have the opportunity to discuss and document their future healthcare wishes if they choose to. SN - 1472-684X UR - https://www.unboundmedicine.com/medline/citation/25903912/Current_advance_care_planning_practice_in_the_Australian_community:_an_online_survey_of_home_care_package_case_managers_and_service_managers_ L2 - https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-015-0018-y DB - PRIME DP - Unbound Medicine ER -