ACP C: Difference between revisions

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*[http://www.wrha.mb.ca/professionals/acp/index.php WRHA ACP C]
*[http://www.wrha.mb.ca/professionals/acp/index.php WRHA ACP C]


== Discussion ==
== Definitions ==
=== ACP C Options ===
{{Potential  Change}}
{{Potential  Change}}
QI TEAM, Kendiss Olafson etc.  have asked if database team could collect ACP ststus at admission.[[User:TOstryzniuk|Trish Ostryzniuk]] 17:12, 2015 May 29 (CDT)
QI TEAM, Kendiss Olafson etc.  have asked if database team could collect ACP status at admission.[[User:TOstryzniuk|Trish Ostryzniuk]] 17:12, 2015 May 29 (CDT)
*ACP C
*ACP C
*ACP UK (no documented ACP on the chart)
*ACP UK (no documented ACP on the chart)
*ACP R
*ACP R
*ACP M+ (no cardiac recuss but accepting intubation)
*ACP M+ (no cardiac resuss but accepting intubation)
*ACP M- (no recuss/no intubation)
*ACP M- (no resuss/no intubation)
**(If ACP M is just written with no qualifiers then one would classify as ACP M-.  Since a significant proportion of patient do want intubation but do not want CPR, I do think it is useful to distinguish). Kendiss.
**(If ACP M is just written with no qualifiers then one would classify as ACP M-.  Since a significant proportion of patient do want intubation but do not want CPR, I do think it is useful to distinguish). Kendiss.
*** could you clarify the above statement? If you are saying that significant proportion of pt want intubation would the status be marked as ACP M+ and not ACP M- as indicated above?
Collecting ACP status at admission and discharge would allow us to follow:
*-% of patient with documented ACP during ICU
*-Level of care at both admission and discharge
*-% of patients with change in level of care during ICU
*-Level of care at the time of ICU death


*Collecting ACP status at admission and discharge would allow us to follow:
**-% of patient with documented ACP during ICU
**-Level of care at both admission and discharge
**-% of patients with change in level of care during ICU
**-Level of care at the time of ICU death
==question for collectors==
==question for collectors==
{{Discussion}}{{discuss@task}}
{{Discussion}}
is this easy info to get at admission?--[[User:TOstryzniuk|Trish Ostryzniuk]] 17:12, 2015 May 29 (CDT)
is this east info to get at admission?--[[User:TOstryzniuk|Trish Ostryzniuk]] 17:12, 2015 May 29 (CDT)
*Yes, it easy to obtain this information  at the time of admission, it is 9/10 that ACP  is established in ER. Do you want us to collect when a change occurs ( often pt come in as a M and 24-72 hrs later, it is changed to APC -C ,or this occurs much later in the admission as well)--[[User:PStein|PStein]] 08:23, 2015 June 1 (CDT)
*
*I agree with Pat. Is this for ICU and Medicine?--[[User:CMarks|CMarks]] 13:50, 2015 June 1 (CDT)
*I agree with Pat's comment. The pt would come in as ACP R & the status would be changed once discussion with family or pt took place.  This usually happens 24-48 hours after admission or much later in the admission if pt status changes or the family cannot agree on the treatment plan. Judy K, jun 4, 2015
*yes, at GGH ICU this is easy to obtain, I agree with Pat the ACP status often changes several times during an admission, do you want to capture these changes? or just ACP at admission and discharge?  Is this ICU only? or medicine as well? [[User:Lkaita|Lisa Kaita]] 11:09, 2015 June 1 (CDT)
=== Define "upon admission" ===
*At STB obtaining ACP is done from EPR and the changes are in the orders. It is easy to obtain.--[[User:LKolesar|LKolesar]] 11:22, 2015 June 1 (CDT)
{{Discussion}}
*Yes it is usually on the chart. Is this going to be just for ICUs. Lois
*Would this include up to the first 24 or 48 hours, or would this need to be in place before arrival?
**ICU QI team has requested to collect this info.  We will discuss at TASK team meeting and discuss asking Dr. Roberts for medicine. 
***I agree that is is usually easy to obtain. I find that it is often an "R" as a default until the MD has a chance to speak more in depth with family or the patient. So yes, it does often change throughout the stay, and my concern would be that the initial ACP status is not always the most "accurate" representation. So if it changes within the first 24 to 48 hours, which one would we enter? [[User:Mlagadi|Mlagadi]] 09:05, 2015 June 2 (CDT)
*not always available on admission to Medicine but is always discussed at some point in the admission; often changes during stay  [[User:SCortilet|SCortilet]] 15:13, 2015 June 2 (CDT)
*Same as Lois-usually on chart or the request is made for confirmation if not: or if the medical status on presentation is suggestive of a need for clarification or adjustment but that would require a time frame to arrange with client/family.--[[User:Llemoine|Llemoine]] 07:46, 2015 June 3 (CDT)


[[Category:End-of-life related data]]
[[Category: Take to Task team meeting]]
[[Category:Take to Task team meeting]]
[[Category: End-of-life related data]]

Revision as of 12:33, 2015 June 4

ACP C stands for Advanced Care Plan. C = Comfort Care-Goals of Care and interventions are directed at maximal comfort, symptom control and maintenance of quality of life excluding attempted resuscitation

For more information see: PDF of ACP form used in Region (2013): WRHA Advanced Care Plan Form

In terms of our program, the concept is related to end of life data.

see also

Definitions

ACP C Options

Template:Potential Change QI TEAM, Kendiss Olafson etc. have asked if database team could collect ACP status at admission.Trish Ostryzniuk 17:12, 2015 May 29 (CDT)

  • ACP C
  • ACP UK (no documented ACP on the chart)
  • ACP R
  • ACP M+ (no cardiac resuss but accepting intubation)
  • ACP M- (no resuss/no intubation)
    • (If ACP M is just written with no qualifiers then one would classify as ACP M-. Since a significant proportion of patient do want intubation but do not want CPR, I do think it is useful to distinguish). Kendiss.
      • could you clarify the above statement? If you are saying that significant proportion of pt want intubation would the status be marked as ACP M+ and not ACP M- as indicated above?

Collecting ACP status at admission and discharge would allow us to follow:

  • -% of patient with documented ACP during ICU
  • -Level of care at both admission and discharge
  • -% of patients with change in level of care during ICU
  • -Level of care at the time of ICU death

question for collectors

Template:Discussion is this east info to get at admission?--Trish Ostryzniuk 17:12, 2015 May 29 (CDT)

  • I agree with Pat's comment. The pt would come in as ACP R & the status would be changed once discussion with family or pt took place. This usually happens 24-48 hours after admission or much later in the admission if pt status changes or the family cannot agree on the treatment plan. Judy K, jun 4, 2015

Define "upon admission"

Template:Discussion

  • Would this include up to the first 24 or 48 hours, or would this need to be in place before arrival?
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