Are completed ReSPECT plans facilitating person-centred care? An evaluation of completed plans in UK general practice

Background: The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) includes agreed clinical recommendations for a person’s care in a future emergency which have been informed by discussion of the person’s preferences. Previous evaluation of ReSPECT plans in acute NHS hospitals found...

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Main Authors: Caroline J. Huxley, Karin Eli, Claire A. Hawkes, Frances Griffiths, Martin Underwood, Gavin D. Perkins, Hazel Blanchard, Jenny Harlock, Julia Walsh, Anne-Marie Slowther
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Resuscitation Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666520424002315
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author Caroline J. Huxley
Karin Eli
Claire A. Hawkes
Frances Griffiths
Martin Underwood
Gavin D. Perkins
Hazel Blanchard
Jenny Harlock
Julia Walsh
Anne-Marie Slowther
author_facet Caroline J. Huxley
Karin Eli
Claire A. Hawkes
Frances Griffiths
Martin Underwood
Gavin D. Perkins
Hazel Blanchard
Jenny Harlock
Julia Walsh
Anne-Marie Slowther
author_sort Caroline J. Huxley
collection DOAJ
description Background: The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) includes agreed clinical recommendations for a person’s care in a future emergency which have been informed by discussion of the person’s preferences. Previous evaluation of ReSPECT plans in acute NHS hospitals found inconsistencies in recording patient’s preferences and involvement in the plan, and infrequent justification for recommendations. Aim: To explore to what extent ReSPECT recommendations reflect individual preferences, as documented in the plan. Methods: ReSPECT plans of adults were collected from 11 General Practices in England. We adapted an evaluation tool used previously to analyse ReSPECT plans in acute settings. Free text sections for individual values/preferences and clinical recommendations were examined for clarity, consistency and congruency between them. Results: We retrieved 141 ReSPECT plans. Patients or those close to the patient were recorded as being consulted in most plans (94%). Individual preferences were completed in 57% of plans. Clinical recommendations reflected individual preferences by directly referencing the person and their preferences (31%), by being consistent with the documented preferences (30%), or by using the same wording as the preferences (6%). Conclusion: While many clinical recommendations reflect individual preferences, the preferences themselves are only recorded in just over half of ReSPECT plans. This is problematic, because the recording of individual preferences facilitates person-centred care, both directly by informing recommendations and indirectly when used to guide decision-making in situations not anticipated in the plan. Future training for clinicians should emphasize the need to document the personal values section of the plan.
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spelling doaj-art-ead5fea2e61a4413a16dcc39664cfa0f2025-08-20T02:32:21ZengElsevierResuscitation Plus2666-52042024-12-012010078010.1016/j.resplu.2024.100780Are completed ReSPECT plans facilitating person-centred care? An evaluation of completed plans in UK general practiceCaroline J. Huxley0Karin Eli1Claire A. Hawkes2Frances Griffiths3Martin Underwood4Gavin D. Perkins5Hazel Blanchard6Jenny Harlock7Julia Walsh8Anne-Marie Slowther9Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United Kingdom; Corresponding author.Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United KingdomFlorence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8AW, United KingdomWarwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United KingdomWarwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United KingdomWarwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United KingdomForrest Medical Centre, 6 Prior Deram Walk, Coventry CV4 8FT, United KingdomWarwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United KingdomWarwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United KingdomWarwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, United KingdomBackground: The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) includes agreed clinical recommendations for a person’s care in a future emergency which have been informed by discussion of the person’s preferences. Previous evaluation of ReSPECT plans in acute NHS hospitals found inconsistencies in recording patient’s preferences and involvement in the plan, and infrequent justification for recommendations. Aim: To explore to what extent ReSPECT recommendations reflect individual preferences, as documented in the plan. Methods: ReSPECT plans of adults were collected from 11 General Practices in England. We adapted an evaluation tool used previously to analyse ReSPECT plans in acute settings. Free text sections for individual values/preferences and clinical recommendations were examined for clarity, consistency and congruency between them. Results: We retrieved 141 ReSPECT plans. Patients or those close to the patient were recorded as being consulted in most plans (94%). Individual preferences were completed in 57% of plans. Clinical recommendations reflected individual preferences by directly referencing the person and their preferences (31%), by being consistent with the documented preferences (30%), or by using the same wording as the preferences (6%). Conclusion: While many clinical recommendations reflect individual preferences, the preferences themselves are only recorded in just over half of ReSPECT plans. This is problematic, because the recording of individual preferences facilitates person-centred care, both directly by informing recommendations and indirectly when used to guide decision-making in situations not anticipated in the plan. Future training for clinicians should emphasize the need to document the personal values section of the plan.http://www.sciencedirect.com/science/article/pii/S2666520424002315Recommended Summary Plan for Emergency Care and Treatment (ReSPECT)Emergency care treatment plans (ECTPs)Person-centred care
spellingShingle Caroline J. Huxley
Karin Eli
Claire A. Hawkes
Frances Griffiths
Martin Underwood
Gavin D. Perkins
Hazel Blanchard
Jenny Harlock
Julia Walsh
Anne-Marie Slowther
Are completed ReSPECT plans facilitating person-centred care? An evaluation of completed plans in UK general practice
Resuscitation Plus
Recommended Summary Plan for Emergency Care and Treatment (ReSPECT)
Emergency care treatment plans (ECTPs)
Person-centred care
title Are completed ReSPECT plans facilitating person-centred care? An evaluation of completed plans in UK general practice
title_full Are completed ReSPECT plans facilitating person-centred care? An evaluation of completed plans in UK general practice
title_fullStr Are completed ReSPECT plans facilitating person-centred care? An evaluation of completed plans in UK general practice
title_full_unstemmed Are completed ReSPECT plans facilitating person-centred care? An evaluation of completed plans in UK general practice
title_short Are completed ReSPECT plans facilitating person-centred care? An evaluation of completed plans in UK general practice
title_sort are completed respect plans facilitating person centred care an evaluation of completed plans in uk general practice
topic Recommended Summary Plan for Emergency Care and Treatment (ReSPECT)
Emergency care treatment plans (ECTPs)
Person-centred care
url http://www.sciencedirect.com/science/article/pii/S2666520424002315
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