How healthcare systems evaluate their advance care planning initiatives: Results from a systematic review

Biondo, Patricia; Lee, Lydia D; Simon, Jessica

doi:10.1177/0269216316630883

Cited by 40 publications

(42 citation statements)

References 20 publications

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“…The papers included in this review achieved a meaningful evaluation when nurses or midwives were able to identify stakeholders, identify and explain outcomes and generate transferable lessons. Similar benefits derived from using frameworks for evaluation are reported in other studies (Biondo et al., ). An additional noted advantage of using one particular framework across studies is the comparison of implementation issues and outcomes across different settings (Bailey & Kerlin, ; Gaglio, Shoup, & Glasgow, ).…”

Section: Recommendations For Use Of Evaluation Frameworksupporting

confidence: 84%

“…Similar benefits derived from using frameworks for evaluation are reported in other studies (Biondo et al, 2016). An additional noted advantage of using one particular framework across studies is the comparison of implementation issues and outcomes across different settings (Bailey & Kerlin, 2015;Gaglio, Shoup, & Glasgow, 2013).…”

Section: Recommendati On S For Us E Of E Valuation Fr Ame Work Smentioning

confidence: 58%

“…Given that evaluations of healthcare initiatives often fail to measure important experience and outcome measures (Biondo et al, 2016) and thus fail to effect change (Ferrer & Goodwin, 2014), our findings highlight the reported advantages of using frameworks when undertaking an evaluation. Use of an evaluation framework is one strategy to both strengthen and simplify the process of evaluation.…”

Section: Rele Van Ce For Clini C Al Pr Ac Ti Cementioning

confidence: 72%

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Evaluation frameworks in health services: An integrative review of use, attributes and elements

Bradford

Chambers

Hudson

et al. 2019

Journal of Clinical Nursing

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Aims and objective To synthesise the evidence on the use of evaluation frameworks by nurses and midwives in research designed to improve healthcare services and practice. A secondary aim was to identify the attributes and elements of evaluation frameworks. Background Evaluation is an integral component of any initiative to improve outcomes or change clinical practice. Yet often an evaluation may not yield the information required to sustain or integrate an initiative into practice. Evaluation frameworks can support effective evaluations, but there is a lack of consensus regarding elements and attributes of frameworks that support use. Methods We undertook an integrative review to synthesise the use of evaluation frameworks in practice guided by the Preferred Reporting Items for Systematic review and Meta‐Analysis flow diagram and checklist 2009 (Supporting Information File 4). The protocol was registered with PROSPERO (CRD42018087033). A broad range of electronic databases were systematically searched using keywords. Findings Twenty‐five papers were included from a diverse range of clinical areas and across high‐, middle‐ and low‐income nations. Twenty of the research projects had used nine existing frameworks, and five had developed an evaluation specific to an initiative. Frameworks supported the processes of evaluation and made them more meaningful by simplifying a complex process (providing structure and guidance for the evaluation processes); identifying and including stakeholders; explaining reasons for outcomes; generating transferable lessons; and identifying the mechanisms driving or inhibiting change. Conclusion Nurses and midwives reported that frameworks were useful in undertaking evaluations. Each framework had positive attributes and missing or confusing elements. When undertaking an evaluation, it is pertinent to review the elements and attributes of a framework to ensure it includes evaluation measures that are relevant to specific projects. Relevance to clinical practice Nurses are actively involved in evaluation of clinical practice. This review identifies important elements to consider when choosing a framework for evaluation.

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Section: Recommendations For Use Of Evaluation Frameworksupporting

confidence: 84%

Section: Recommendati On S For Us E Of E Valuation Fr Ame Work Smentioning

confidence: 58%

Section: Rele Van Ce For Clini C Al Pr Ac Ti Cementioning

confidence: 72%

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Evaluation frameworks in health services: An integrative review of use, attributes and elements

Bradford

Chambers

Hudson

et al. 2019

Journal of Clinical Nursing

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“…(1, 2, 4) However, studies have used a wide variety of outcomes to measure the success of ACP programs and interventions, including advance directive completion, behavior change, healthcare utilization, and care consistent with goals, all of which have been variably measured. (5–10)…”

Section: Introductionmentioning

confidence: 99%

Outcomes That Define Successful Advance Care Planning: A Delphi Panel Consensus

Sudore

Heyland

Lum

et al. 2018

Journal of Pain and Symptom Management

275

277

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Context Standardized outcomes that define successful advance care planning (ACP) are lacking. Objective To create an Organizing Framework of ACP outcome constructs and rate the importance of these outcomes. Methods This study convened a Delphi panel consisting of 52 multidisciplinary, international ACP experts including clinicians, researchers, and policy leaders from four countries. We conducted literature reviews and solicited attendee input from 5 international ACP conferences to identify initial ACP outcome constructs. In 5 Delphi rounds, we asked panelists to rate patient-centered outcomes on a 7-point “not-at-all” to “extremely important” scale. We calculated means and analyzed panelists’ input to finalize an Organizing Framework and outcome rankings. Results Organizing Framework outcome domains included process (e.g., attitudes), actions (e.g., discussions), quality of care (e.g., satisfaction), and healthcare (e.g., utilization). The top 5 outcomes included (1) care consistent with goals, mean 6.71 (±SD 0.04); (2) surrogate designation, 6.55 (0.45); (3) surrogate documentation, 6.50 (0.11); (4) discussions with surrogates, 6.40 (0.19); and (5) documents and recorded wishes are accessible when needed 6.27 (0.11). Advance directive documentation was ranked 10th, 6.01 (0.21). Panelists raised caution about whether “care consistent with goals” 6.01 (0.21). Panelists raised can be reliably measured. Conclusion A large, multidisciplinary Delphi panel developed an Organizing Framework and rated the importance of ACP outcome constructs. Top rated outcomes should be used to evaluate the success of ACP initiatives. More research is needed to create reliable and valid measurement tools for the highest rated outcomes, particularly “care consistent with goals.”

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“…A total of 19 patients have shared their wishes and preferences with family members (6), or community teams (13). Of these 13 patients, 12 have subsequently died.…”

Section: Resultsmentioning

confidence: 99%

Assessing Advance Care Plan Discussions in Hospice Day Care

Johnstone

Poolman²,

Ryan³

et al. 2017

Palliat Med Hosp Care Open J

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Background: Advance care planning (ACP) is a voluntary discussion between an individual and their care providers. The primary purpose is to identify and document a person's wishes and preferences for future care. Method: Within Betsi Cadwaladr University Health Board (BCUHB) an ACP document which records the process of advance care planning has been developed, piloted and approved for use within North Wales. The BCUHB ACP document can be used to structure and document ACP discussions with patients. It is a patient-held record of these discussions that with the consent of the patient may be shared if appropriate with those important to the patient and/or healthcare professionals. ACP discussion opportunities and documentation of patients' wishes and preferences for future care have been introduced into hospice day care in North Wales. Outcomes: This paper reports on the preliminary outcomes, lessons learnt and how they are informing the way forward with this challenging local initiative whilst contributing to the international ACP picture.

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How healthcare systems evaluate their advance care planning initiatives: Results from a systematic review

Cited by 40 publications

References 20 publications

Evaluation frameworks in health services: An integrative review of use, attributes and elements

Evaluation frameworks in health services: An integrative review of use, attributes and elements

Outcomes That Define Successful Advance Care Planning: A Delphi Panel Consensus

Assessing Advance Care Plan Discussions in Hospice Day Care

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