An innovative Bevan Exemplar project has won the award for Quality Improvement in Patient Care at the Royal College of Physicians Excellence in Patient Care Awards. The team, led by Dr Mark Taubert at Velindre Cancer Centre and James Norris from the Digital Legacy Association, produced public on-line videos and a website to encourage conversation about the tricky subject of CPR.
Many patients have limited information about what CPR involves, aside from what they might have seen on television. Without much information about what the procedure involves, patients are unable to fully express their views and preferences. Alongside this, the palliative care team at Velindre Cancer Centre observed that healthcare professionals often found it difficult to discuss CPR and DNACPR (Do Not Attempt Cardiopulmonary Resuscitation Orders.) with patients, sometimes leading to distress. They recognised that a new approach was needed.
The TalkCPR training was created to improve the confidence of professionals when having these discussions. Videos were developed jointly by patients, relatives and a range of clinical staff and they aim to encourage open discussion about CPR when people are facing serious illness. This is a key part of advance care planning, which can reduce distress at a later stage in a person’s illness.
The online videos are freely available on the TalkCPR website and YouTube and the training is now a national information package, rolled out across the whole of NHS Wales. Hand-held video books were sent to all GP practices to help GPs have these discussions with patients who want to think about their future care.
This unique project is a world first – helping palliative care patients and families talk openly about what they do or do not want to happen. The team have found that patients, relatives and professionals value these discussions, as they are properly informed in a gentle, sensitive way through the videos. The team hopes that discussions on CPR and DNACPR can become a normalised part of conversations between patients and healthcare professionals.
Dr Mark Taubert, Consultant in Palliative Medicine at Velindre NHS Trust, said: “I hope the website can empower patients and their loved-ones to really turn the table on these anticipatory healthcare discussions."
James Norris from the Digital Legacy Association, said “TalkCPR has been a great awareness campaign and the Digital Legacy Association are proud to be part of the TalkCPR team. CPR and DNACPR are very difficult subject matters for professionals and the general public to address. The goal of TalkCPR is to help break down barriers and make CPR and DNACPR easier subject matters to learn about, discuss and address.”
Baroness Dr Ilora Finlay, Bevan Commissioner, said: “The award for TalkCPR recognises how this innovative approach is making a difference in a vital area of care that potentially affects us all. Talking about cardiac arrest and death is difficult; the TalkCPR website helps people understand the issues involved in deciding whether they want CPR attempted and the importance of high standards of care whether or not a DNACPR decision has been addressed. This award is very well deserved and recognises this high quality innovative work.”
The project was supported by the Bevan Commission as part of the Bevan Exemplars programme. Read more about the Bevan Exemplars programme here.