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Development and implementation of an advance care planning program in Catalonia, Spain

Published online by Cambridge University Press:  05 October 2018

Cristina Lasmarías ,
Amor Aradilla-Herrero ,
Sebastià Santaeugènia ,
Carles Blay ,
Sara Delgado ,
Sara Ela ,
Núria Terribas  and
Xavier Gómez-Batiste Open the ORCID record for Xavier Gómez-Batiste [Opens in a new window]
Cristina Lasmarías
Affiliation:
The Qualy Observatory-World Health Organization Collaborating Center for Public Health Palliative Care Programs (WHOCC-ICO), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain Chair of Palliative Care, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain Catalonia Chronic Care Research Group, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
Amor Aradilla-Herrero
Affiliation:
Escuela Universitaria de Enfermería Gimbernat, Autonomous University of Barcelona, Sant Cugat del Vallès, Barcelona, Spain
Sebastià Santaeugènia
Affiliation:
Catalonia Chronic Care Research Group, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain National Strategy of Integrated and Chronic Care, Ministry of Health, Government of Catalonia, Barcelona, Spain
Carles Blay
Affiliation:
Catalonia Chronic Care Research Group, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain Medicine, University of Vic - Central University of Catalonia, Vic, Barcelona, Spain
Sara Delgado
Affiliation:
St Luke's Hospice, London, United Kingdom
Sara Ela
Affiliation:
The Qualy Observatory-World Health Organization Collaborating Center for Public Health Palliative Care Programs (WHOCC-ICO), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain Chair of Palliative Care, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
Núria Terribas
Affiliation:
Chair of Bioethics, University of Vic-Central University of Catalonia, Fundació Grifols, Barcelona, Spain
Xavier Gómez-Batiste*
Affiliation:
The Qualy Observatory-World Health Organization Collaborating Center for Public Health Palliative Care Programs (WHOCC-ICO), Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain Chair of Palliative Care, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain Catalonia Chronic Care Research Group, University of Vic-Central University of Catalonia, Vic, Barcelona, Spain
*
Author for Correspondence: Xavier Gómez- Batiste Alentorn, MD, PhD, The Qualy Observatory-WHO Collaborating Center for Public Health Palliative Care Programs (WHOCC-ICO), Catalan Institute of Oncology, Avinguda Gran Via de L'Hospitalet, 199-203 08908 L'Hospitalet de Llobregat, Barcelona, Spain. E-mail: xgomez.whocc@iconcologia.net
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Abstract

Objective

Implementation of an advance care planning (ACP) program for people with advanced chronic conditions is a complex process. The aims of this paper are to describe (1) the development of the ACP program in Catalonia, Spain, for patients with advanced chronic conditions and complex needs and (2) the preliminary results of the implementation of this program in health and social services.

Method

The ACP program was developed and implemented in a four-stage process as follows: (1) design and organization of the project; (2) selection of the professionals to carry out the project; (3) creation of four working groups to develop the conceptual model, guidelines, training program, and perform a qualitative evaluation; and (4) project implementation.

Result

The following deliverables were completed: (1) conceptual framework document; (2) practical guidelines for the application of the ACP; (3) online training course (3,763 healthcare professionals completed the online course, with an overall satisfaction rating of 8.4 on a 10-point scale); and (4) additional training activities (conferences, short courses, and seminars) in between 2015 and 2017.

Significance of results

This project was led by the Catalan Ministry of Health. The strengths of the project development include the contribution of a wide range of professionals from the entire region, approval by the Catalan Bioethics Committee and the Social Services Ethics Committee, and the ongoing validation by members of the community. A standardized online training course was offered to all primary care professionals and included as a quality indicator for continuing education for those professionals in the period 2016–2020. The main outcome of this project is the establishment of a pragmatic ACP throughout the region and training of the health and social care professionals involved in the care of advanced chronic patients.

Keywords

Advance care planningChronic diseasesHealth plan implementationPalliative careTraining
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 4 , August 2019 , pp. 415 - 424
Copyright
Copyright © Cambridge University Press 2018 

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