958 A Study on Electronic Treatment Escalation Plan (TEP) Forms Completion and Compliance
S Pattnaik, A Zarifian, S Punwar, G A Sidhu- Surgery
Abstract
Aim
Establishing a Treatment Escalation Plan (TEP) allows doctors to discuss and record patient preferences in advance, in addition to cardiopulmonary resuscitation (DNA-CPR), but also for various aspects of emergency care and treatment.This study examines the overall rates of TEP form completion, as well as completion within 48 hours of the patient's hospitalization, as observed in routine practise at a DGH.
Method
This study was conducted utilising PDSA (Plan-Do-Study-Act) cycles and a cross-sectional methodology, auditing all adult in-patients admitted to the hospital for Orthopaedic surgery.The first cycle occurred in March 2022, followed by interventions in the form of an institutional algorithm, and the second cycle followed in November 2022.
Results
In the first cycle, 69.5% of patients had a completed TEP form, with 47.8% filling one within 48 hours of admission.It took an average of 4.4 days to complete, with 3.2 overrides. Following intervention and discussion in departmental meetings, 88.2% of tasks were completed, with 35.2% ended within 48 hours. Average days rose to 3.7 days, and overrides fell to 1.3 times. A questionnaire developed for the juniors to ask them about their reasons for noncompliance, and it was realised that the majority of them were concerned about the legal ramifications, correspondence with the patient and family, and a small percentage were due to a lack of time.
Conclusions
When juniors are fully informed of the technique to complete TEP forms, completion rates increase significantly. The process would be maintained under control by regular audits and training for rotating juniors.