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Using the Recommended Summary Plan for Emergency Care and Treatment in Primary Care: a mixed methods study
Anne-Marie Slowther1, Jenny Harlock1, Celia J Bernstein1
1Warwick Medical School, University of Warwick, Coventry, UK.
Health and Social Care Delivery Research
|November 2, 2024
Summary
The ReSPECT plan is supported by the public and professionals for emergency care decisions. However, translating patient wishes into specific recommendations in primary care presents challenges, leading to varied interpretations.
Area of Science:
- Healthcare delivery research
- Emergency medicine
- Patient care planning
Background:
- The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) was developed in 2016.
- Initiating ReSPECT in primary care presents potential advantages and difficulties.
- Discrepancies exist in how hospital doctors and general practitioners utilize ReSPECT, impacting recommendation translation between settings.
Purpose of the Study:
- To evaluate the utilization of ReSPECT in primary care settings.
- To assess the impact of ReSPECT on patient treatment and care.
- To understand the contextual factors influencing ReSPECT implementation.
Main Methods:
- A mixed-methods study incorporating interviews, focus groups, and surveys.
- Analysis utilized normalisation process theory.
- ReSPECT forms were evaluated across 13 general practices and 13 care homes in England.
Main Results:
- Public and professionals support ReSPECT, viewing it as person-centred.
- 41% of GPs surveyed used ReSPECT, with users more comfortable discussing emergency care.
- Challenges include translating future uncertainties into specific recommendations, leading to conflicts in care decisions.
Conclusions:
- ReSPECT's aims are broadly supported, but implementation in community settings faces challenges.
- Uncertainty in clinical trajectories complicates specific recommendation generation.
- Variations in interpretation and application of ReSPECT recommendations were observed.
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