ACP Status Collection
| Projects | |
| Active?: | planned |
| Program: | CC and Med |
| Requestor: | Dr. Roberts |
| Collection start: | 2026-06-?? |
| Collection end: | |
This article is about collecting the "ACP Status" (Advanced Care Planning) temp entry. See ACP Status Collection over time for related collections.
Purpose
We collect ACP status as a quality indicator that reflects documentation (e.g. completed ACP form or Admitting Orders) and discussion of goals of care for all patients admitted to ICU or medicine.
Collection Instructions
- For each new record, use the last documented ACP status in the chart prior to admission date, a date and time is NOT required
- on admission, collect the first ACP status documented by a physician only
- At discharge, collect the last ACP status documented by a physician only
- Only use ACP forms made during same hospitalization (e.g. ACP status documented by ER, or ward or on prior ICU/ward for transferred patients)
Sources
- ACP PTA
- ACP forms from previous hospitalizations, PCH, health directives can be used to determine the ACP status prior to admission. If the last ACP status prior to admission cannot be readily found within the current chart, enter not documented.
- ACP first
- ACP form, orders, notes
- SBGH EPR- go to EPR orders. Under "transfers and care directives" there should be an order that states, "advanced care planning goals of care" with the ACP status listed (this also displays in the top of the EPR individual patient demographic information). If you double click on the order, the ACP electronic form displays (it is exactly the same as the paper form which was previously used). When the physician writes the order, the form automatically is populated with the doctor name and the ACP status also. However, if there are special conditions or comments, the doctor may fill out parts of the form itself separately from the displayed order.
- ACP Last
- ACP form, order, notes
- SBGH EPR as per above instruction
Data Entry Instructions
For every new record, an entry of "not entered" will be automatically generated.
Update that line to one of the following:
- Project: ACP PTA
- Items:
- not yet entered (automatic entry)
- ACP-C
- ACP-M
- ACP-R
- not documented
- Date/Time, Checkbox, Integer, Real: not used
- Items:
|
does the ACP Status PTA need to be documented by a physician or can it be documented by another discipline? Lisa Kaita 16:33, 24 June 2025 (CDT) |
- Project: ACP first
- Items:
- not yet entered (automatic entry)
- ACP-C
- ACP-M
- ACP-R
- not documented
- Items:
- Date/Time: dttm of the status decision
- if decision was made before admission, use the first service Admit DtTm
- if a time is not available, Use the best estimate for the time. If there is no estimate at all, use noon, or the closest to noon that the data integrity checks will allow. Note, the ACP form does not have a field for time entry, so if there is documentation on the orders or notes with a time entry, use the earliest date and time documented
- Project: ACP last
- Items:
- not yet entered (automatic entry)
- ACP-C
- ACP-M
- ACP-R
- not documented
- Items:
- Date/Time: dttm of the status decision
- if a time is not available, Use the best estimate for the time. If there is no estimate at all, use noon, or the closest to noon that the data integrity checks will allow.
- if the ACP last status is the same as the ACP first status, enter the same ACP status as the first, and check the checkbox for dttm
- if the ACP last status is different than ACP first status, enter the last documented ACP Status and the dttm that it was changed, if there is no time use the best estimate for the time. If there is no estimate at all, use noon, or the closest to noon that the data integrity checks will allow.
- If a patient is deteriorating quickly and the ACP status is changed to ACP C, or is in ICU and they withdraw care, do not document this as ACP last status for this project. Use the ACP first status and check the checkbox for dttm.
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IF a patient in this situation continues to live for days, should the ACP status be changed at some point? and if so what timeframe should we use?
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- Comment (optional): If there are multiple ACP status changes/family discussions that are affecting the LOS or seem unusual, leave this as a comment in the "Q" column, NOT the notes section
- Checkbox, Integer, Real: not used
Question
- if status is documented as "presumed ACP R" should we capture this as ACP R or not documented?
- then you enter "not documented" (but maybe we need to fine-tune the wording)
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Dan do you agree with this? Lisa Kaita 16:33, 24 June 2025 (CDT) |
WRHA/SH guidelines / forms
Cross Checks
Data use / Reporting and Analysis
- The Critical Care QI team expects the following data from this project
- Variables: ACP Status, Date of ACP form/Order and Source of ACP documentation
- Changes in these over the course of the admission.
- The expected outcome:
- % of patient with and without documented ACP during ICU stay
- Type of timing of ACP documentation
- The sources of ACP documentation
- Level of care at both admission and discharge
- % having ACP R on admission and discharge
- % of patients with no change in level of care during ICU
- % of patients with change in level of care during ICU
- % having ACP status determined during ICU stay
- % having ACP change with decreased intensity
- % having ACP change with increased intensity
- Level of care at the time of ICU death
- Level of care at the time of discharge for survived patients
- the data are saved in table L_TmpV2 under projects "ACP at admit / ACP at end / ACP Status / ACP Source" of the centralized_data.mdb
- the SAS program that reads the data can be found in Template:S:\MED\CCMEDJulie\SAS_CFE\CFE_macros\CFE_CC_ACP.sas
Log
- 2025-06-24 TT split this page off from ACP Status Collection for LAU and reverted that one when it became apparent that it will be substantially different, and edited the S_tmp table
- 2025-06-16 LK, TT, DR met and discussed; LK updated ACP Status Collection for LAU page