Episode 9: Advance Care Planning

In this episode Dr Trevor Chan and Dr Sunita Chacko, both Hospitalists (family physicians) at the Foothills hospital in Calgary, Alberta, discuss the quality improvement (QI) project that they completed for the 2012/13 W21C Patient Safety and Quality Management course called: Conversations Matter. Their project focused on advance care planning as a process rather than a singular event that includes discussions between the patient, improve the overall use of the advance care planning tracking tool, which should be completed for all patients but is often incomplete or not up to date. They used a number of different interventions such as family, and healthcare providers as well as a good understanding of the disease process and prognosis.

Advance care planning is much more than a goal of care designation, which it is often confused with by physicians.Sunita and Trevor completed a short PDSA (plan, do, study, act) cycle to education for the physicians and unit managers, engagement of leaders, and visual feedback in the clinical setting and then performed chart audits to determine how many tracking tools were complete and up to date before, during, and after their interventions

After listening to this podcast listeners will be able to:
1.  Define the difference between Advance Care Planning and Goal of Care Designations
2.  List the interventions that Trevor and Sunita used in their project and which were most successful
3.  Describe how advance care planning conversations, and especially the tracking tool, can positively affect patient safety and quality of care
4.  Discuss some of the barriers that physicians encounter that could decrease their use of the tracking tool

Sunita Chacko MD, MSc
Sunita Chacko is a family physician in Calgary, Alberta. She divides her practice between inpatient care as a Hospitalist at Foothills Medical Center and outpatient care with marginalized adolescents at the Alex Youth Health Centre. She also serves as the chair of the Calgary Hospitalist Innovation Committee (CHIC), overseeing Hospitalist driven quality improvement (QI) initiatives from multiple acute care and community sites in the Calgary Zone.

Trevor Chan MD
Trevor Chan is a family physician in Calgary, Alberta.

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Participants in the Patient Safety and Quality Management Course, run by the W21C, with the University of Calgary, and the HQCA (Health Quality Council of Alberta), complete a quality improvement (QI) project and then present their findings through a poster and short presentation at the end of the course. Trevor and Sunita won the award for best poster/presentation for the 2012/2013 Patient Safety and Quality Management Course.

Take a closer look at Sunita and Trevor’s project by clicking on the image of their poster.