Implementing a process for resuscitation planning: Queensland health’s experience

Queensland Health, like all Australian jurisdictions, is meeting the challenge of providing better end of life care and planning for all Queenslanders. A number of recent, high-profile Coronial findings adjusted the priority from the broader end of life agenda to an increased focus on resuscitation planning. In the context of advance care planning, resuscitation planning represents a subset, yet is an integral part of how we respond to some of our most vulnerable patient groups – those who are chronically ill and for whom there is a reasonably foreseeable risk of cardiac and/or respiratory arrest.

Queensland Health is implementing an “Acute Resuscitation Plan” (ARP) form in all 149 of its facilities in early 2010. The ARP form will replace all NFR Orders currently written in patient’s charts. The ARP is a clinician form rather than a patient form and was successfully piloted in six Queensland Health hospitals during May and June 2009.

State-wide implementation of the ARP will be supported by clinician education and training modules, toolkits, including patient brochures. Statewide implementation of the ARP is designed to improve:

 1. documentation in the area of resuscitation planning;

 2. outcomes for those patients at the end of life by providing a structured process
     for clinicians to initiate discussions about resuscitation planning, with the view to
     talking to patients and their families about advance care planning;
 
 3. clinical practice for all health professionals through better understanding of the
     decision-making process around resuscitation planning; and

 4. clinician satisfaction with the form and its processes.