Having conversations to understand and record a person’s wishes has never been more important than during the current COVID-19 pandemic. Read this document from the Resus Council clarifying what the ReSPECT Process can do to help facilitate conversation.
ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) has been developed by the UK Resuscitation Council. It is currently being implemented in various locations across the country.
The aim of the project in the West of England is to understand whether the ReSPECT process offers confidence and an effective framework for encouraging and empowering staff to have these important conversations with their patients. We aim to explore and identify barriers to supporting patient’s wishes as documented on a ReSPECT form from an organisational, system and cultural perspective.
The training package
Training resources are available to download and adapt for your local setting. To register for our sharing site please email email@example.com. There are three levels to our training package:
ReSPECT Level 1: Awareness
Training to teach staff how to recognise the form, and what it stands for.
- What is ReSPECT and how is it different to what we have already?
- Who is ReSPECT for?
- What does the form look like?
ReSPECT Level 2: Action
Training for staff who will need to recognise the form, and act on the recommendations.
- As above plus:
- How to care for someone with a ReSPECT form
- During an emergency where a person is unable to make or express choices
- When to update the form
ReSPECT Level 3: Conversations
Training for staff who will be initiating or carrying out conversations with patients and their families about treatment escalation, DNACPR, and the ReSPECT process.
- As above plus
- Having a conversation about ReSPECT
- Completing the form
- Communicating the form
- The ReSPECT form, legal status and relationship with other areas
Please note the ReSPECT form itself should not be altered or added to in any way.
Why do we need ReSPECT?
“Empowering people to make informed decisions about their care is an essential part of a person-centred approach to healthcare and nowhere is this more important than in decisions about life and death. The ReSPECT process was developed to help ensure that these decisions are made correctly, and as far as possible in accordance with a person’s own wishes. We believe this will improve the quality of care and lead to a culture shift with emergency and end of life care.” — Federico Moscogiuri, Chief Executive, Resusciation Council (UK).
Too few of our most frail and complex patients have advance care plans that describe what should happen in an emergency. This means that clinicians and carers have to make decisions about a person’s best interests and preferences and some very frail patients are resuscitated when they would not wish to be.
Many people are also taken to hospital in an emergency when they would have preferred to stay at home. They often recover much more slowly in hospital than they would have in more familiar surroundings.
Ensuring there are high-quality advance care plans, accessible to the clinicians who need them, enables better care for patients, peace of mind for their carers and greater satisfaction for staff who can be confident they are following their patients’ wishes.
The roll-out of ReSPECT in the West of England is one part of a national Patient Safety Collaborative strategy to improve the care of patients at risk of deterioration. We will do this by improving the reliability of recognition, response and escalation (the three main domains within deterioration), underpinned by excellent communication between professionals and with patients.
- Recognition: The expedient recognition of deterioration through reliable monitoring, identification and assessment of all patients’ conditions in all environments.
- Response: the reliable activation, timely response and communication of deterioration.
- Escalation: the reliable escalation and de-escalation of clinical interventions and review by senior clinicians, to include advance care planning to reduce inappropriate care.