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Refining an Advance Care Planning Implementation Assessment Tool for Nursing Homes (ACP-QAT): A Delphi Study
Peiyuan Zhang1, Nancy Kusmaul2,3, Joan Davitt2
1University of Alabama School of Social Work, Tuscaloosa, AL, USA.
Summary
Advance care planning (ACP) in nursing homes improves end-of-life care. Researchers revised the Advance Care Planning Implementation Quality Assessment Tool (ACP-QAT) to better measure ACP quality in these facilities.
Area of Science:
- Gerontology
- Healthcare Quality Improvement
- End-of-Life Care Research
Background:
- Advance care planning (ACP) is crucial for quality end-of-life care.
- Nursing homes care for a significant portion of older adults nearing death.
- Current ACP implementation in U.S. nursing homes is inconsistent.
Purpose of the Study:
- To revise the Advance Care Planning Implementation Quality Assessment Tool (ACP-QAT).
- To establish a reliable measure for assessing nursing home-level ACP implementation quality.
Main Methods:
- Utilized the Delphi method for iterative expert consensus.
- Incorporated feedback from five focus groups in Round 1.
- Panelists rated items, achieving consensus defined by specific statistical criteria.
Main Results:
- Six key categories for revision were identified, leading to 10 item modifications.
- All revised items achieved expert consensus.
- The revised ACP-QAT is the first tool designed for nursing home ACP implementation quality assessment.
Conclusions:
- The revised ACP-QAT offers a validated tool for measuring ACP quality in nursing homes.
- This tool can inform and guide improvements in nursing home policies and practices.
- Enhancing ACP implementation in nursing homes can improve end-of-life care for residents.
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