Final version in round | Round 1 wording | Round 1 relevance [%] | Round 1 feasibility [%] | Round 2 wording | Round 2 relevance [%] | Round 2 feasibility [%] | |
---|---|---|---|---|---|---|---|
I. Advance care planning with patients | |||||||
M1 | 2 | One selected member from the general practice team conducts a structured first assessment with patients receiving PPC and their FCs. | 64.1 | 57.4 | The general practice team conducts a structured first assessment with patients receiving PPC and their FCs. | 85.3 | 76.4 |
M2 | 2 | The general practice team develops, in cooperation with patients receiving PPC, an emergency dataset. The dataset is saved in the general practice and/or perspectively on the electronic health card. | 78.2 | 55.6 | The general practice team develops, in cooperation with patients receiving PPC, an emergency dataset. The dataset is saved in the general practice and distributed to the patient. | 97.0 | 84.9 |
M3 | 2 | GPs identify patients who might benefit from PPC using structured tools (e.g. SPICT). | 68.8 | 75.8 | Drawing on their personal experience with the support of structured tools (e.g. the Supportive and Palliative Care Indicators Tool), general practitioners identify patients who might benefit from PPC. | 81.8 | 78.8 |
M4 | 1 | A filled in and up-to-date crisis paper sheet is kept clearly visible at the palliative patient’s home (e.g. next to his or her bed). | 95.4 | 91.8 | |||
M5 | 1 | The general practice team maintains a copy of each palliative patient’s crisis sheet in the office. | 84.1 | 85.7 | |||
II. Consulting and informing patients and FCs | |||||||
M6 | 1 | Telephone numbers of emergency contacts and proxies, as selected by the patient, are saved in the practice computer system. | 95.3 | 95.2 | |||
M7 | 2 | GPs distribute leaflets with information about palliative care to patients, who could benefit from PPC as well as their FCs. | 79.3 | 83.9 | In addition to making personal consultations, GPs distribute leaflets with information about palliative care to patients who could benefit from PPC, as well as their FCs. | 85.3 | 85.3 |
M8 | 2 | GPs distribute leaflets with internet resources or information on advance directives and/or health care proxies to patients with a potential palliative disease progression. | 71 | 79 | In addition to making personal consultations, GPs distribute leaflets with internet resources or information on advance directives and/or health care proxies to patients with a potential palliative disease progression. | 100 | 97.1 |
M9 | 1 | One selected member of the general practice team informs palliative patients about the possibility of a release of confidentiality restraints between involved service providers, to facilitate cooperation and communication between the practice team and other service providers. | 76.2 | 75.4 | |||
M10 | 1 | GPs inform all patients and their FCs about the standby service outside of regular practice hours. | 76.6 | 87.1 | |||
III. GP office organisation | |||||||
M11 | 1 | Physician assistants refill the home visit bag directly after a completed home visit. | 80.9 | 76.6 | |||
M12 | 2 | One selected member from the general practice team coordinates the care of patients receiving PPC | 68.8 | 68.8 | The general practice team coordinates in joint consultations around the care of patients receiving PPC. If possible/necessary, cooperation with palliative support centres or palliative care teams is initiated. | 88.2 | 85.3 |
M13 | 2 | Medical assistants are responsible for updating the medication plans of all patients. | 52.3 | 47.4 | GPs are responsible for updating the medication plans of patients receiving PPC and reviewing indications on a regular basis. | 97.1 | 97.0 |
M14 | n.c. | Continuing education courses offered internally in general practices are made accessible to further cooperating care providers and/or interested parties, such as home health care services and will be actively advertised. | 63.5 | 50.8 | Continuing education courses offered internally in general practices are made accessible to further cooperating care providers and/or interested parties, such as home health care services. | 64.7 | 51.5 |
M15 | 1 | General practices provide written instructions and options for looking up instructions for rare tasks (e.g. professional association case procedures, rehabilitation requests). | 77.8 | 75.4 | |||
M16 | 1 | When registering patients in the general practice, physician assistants ask patients about their preferences, document their complaints and, if necessary, initiate the first treatment steps (e.g. direct the patient to a specific room for ECG). | 92.2 | 91.9 | |||
M17 | 2 | Provide physician assistants with an undisturbed environment for documentation during working hours. | 90.6 | 59.7 | If the practice rooms allow it, provide physician assistants with an undisturbed environment for documentation during working hours. | 97.1 | 82.4 |
M18 | 1 | The practice team holds regular team meetings. | 96.9 | 92.1 | |||
M19 | 2 | For admission requests to hospices or palliative care units, general practice teams use a standardised fax template. | 67.2 | 80.4 | For admission requests to hospices or palliative care units, general practice teams use a standardised fax template, which can be supplemented with individual annotations. Where necessary, personal contact is initiated to discuss more complex patients. | 91.2 | 85.3 |
IV. Continuing education | |||||||
M20 | 1 | GPs offer internal courses for their physician assistants on e.g. hygiene standards. | 89.0 | 81.9 | |||
M21 | 1 | GPs realize physician assistants’ continuing education requests in a timely manner. | 93.7 | 81.0 | |||
M22 | n.c. | Members of the practice team participate in internal courses on palliative care and end-of-life communication. | 82.5 | 72.1 | Members of the practice team participate in internal or external courses on palliative care and end-of-life communication. | 87.9 | 69.7 |
M23 | n.c. | Members of the practice team participate in internal courses on advance directives and advance care planning. | 59.3 | 60.6 | Members of the practice team participate in internal or external courses on advance directives and advance care planning. | 76.4 | 67.6 |
M24 | n.c. | Physician assistants accompany GPs on home visits to patients receiving PPC, to gain hands-on practical experience in palliative care. | 78.1 | 61.1 | If staffing capacity allows, physician assistants accompany GPs on home visits to patients receiving PPC, to gain hands-on practical experience in palliative care. | 91.2 | 70.6 |
V. Cooperation with other service providers | |||||||
M25 | n.c. | Physician assistants complete an internship at a palliative and/or hospice care provider for one month. | 57.2 | 31.2 | If staffing capacity allows, physician assistants complete an internship at a palliative and/or hospice care provider (e.g. for one week). | 85.3 | 46.9 |
M26 | n.c. | Before a GP is temporarily substituted with another, patients with high demand for care are discussed via a medical information handover during joint home-visits, with a corresponding exchange of documents. | 90.6 | 64.5 | Before a GP is temporarily substituted with another, patients with high demand for care are discussed via a medical information handover over the telephone, with a corresponding exchange of documents. | 97.0 | 73.5 |