What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

There are various forms of care planning documents in use (Treatment Escalation Plans, Anticipatory Care Plans, Do Not Attempt Cardio Pulmonary Resuscitation, Key Information Summary, Emergency Care Summary), which leads to a challenge of sharing accurate and up to date information across Primary and Secondary Care.

There are challenges in having admissions preferences, Cardio Pulmonary Resuscitation recommendations, emergency treatment plans and emergency contact details centralised and digitalised whilst being readily available.

Unnecessary or unwanted admissions to acute wards, delays in accessing the right services and inappropriate Cardio Pulmonary Resuscitation attempts can all occur due to lack of or unavailable cohesive patient information.

Building on the success of the National Education for Scotland Digital ReSPECT project and adoption of the Resuscitation Council UK ReSPECT Process, we can align this through Realistic Medicine through a shared decision making process with a person centred approach.

What does your project aim to achieve?

Adopting the ReSPECT process and digital ReSPECT Plan, shared across platforms, we aim to-;

·       promote the use of ReSPECT as the single, most effective source of truth for emergency care planning

·       increase the number of digital ReSPECT plans created and shared across electronic health platforms in NHS Tayside

·       reduce the number of unwanted or inappropriate admissions to hospital

·       reduce the number of inappropriate Cardio Pulmonary Resuscitation attempts

·       reduce the number of unnecessary 2222 calls

·       increase the percentage (%) of compliance with patient’s Preferred Place of Death

How will the project be delivered?

A pilot period and test for change for an initially low number of users adopting the ReSPECT process and Digital App is coming to an end, with full implementation currently being planned across Tayside.

Taking a collaborative quality improvement approach, the project will implement ReSPECT across primary and secondary care in both acute and community, working with and alongside clinical colleagues, patients and their families.

New user areas are agreed with tailored implementation plans, and Learnpros have been developed and are live, and staff support for all new areas implementing ReSPECT.  Supporting resources will be developed and continually maintained to compliment the process. Reviews and evaluations will be carried out, and lessons learned documented and shared.

Monitoring improvement and performance data (which is also a requirement for RESUS UK) will be done through the Patient Safety team (including a Quality Improvement Nurse, an Improvement Advisor and a ReSPECT Project Manager).

How is your project going to share learning?

A Tayside ReSPECT Users’ Forum is being created for sharing learning, problems, and best practice. The Patient Safety team co-ordinate and promote ReSPECT through our network, and directly through awareness and learning events.

We will also monitor activity and user trends, and involve key ReSPECT users in training and sharing the benefits. Reporting of progress, patient stories and case studies is shared through Realistic Medicine and the Person Centred Leadership Group with governance routes through the CPR Committee.

As part of the National ReSPECT collaborative, we are best placed to feedback, influence and promote our experiences and best practice to other Health Boards. We are also able to drawdown any suggested improvements or enhancements based on National experiences.

We are part of the RESUS UK adopters group where new information and best practice is obtained at regular meetings, and disseminated through our User Forum with training materials updated as required.