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Plan of Treatment for CPR Initiative


When the Do Not Resuscitate Confirmation Form (DNRC) was introduced across the province of Ontario in February 2008, it became apparent that many health care providers were unfamiliar with their obligations under the Health Care Consent Act, 1996 when discussing choices around Cardio Pulmonary Resuscitation (CPR) with patients.
 
The South West Hospice Palliative Care Network (SWHPCN) endorsed a structured approach, the Algorithm for Development of a Plan of Treatment related to CPR and completion of the DNR Confirmation Form (Algorithm), (developed in Grey-Bruce, Ontario, Canada and supported by a wide range of experts across the province of Ontario) which clearly describes the steps health care professionals must take when having discussions about CPR with patients and substitute decision makers. The algorithm identifies who should be involved in the discussion, how the physician’s assessment of whether CPR should be offered fits within the process, what constitutes informed consent, what points should be discussed with the person and/or his/her substitute decision maker, and how to resolve conflicts should they arise.
 
In 2010/11 the South West Hospice Palliative Care Network, in partnership with the Palliative Pain and Symptom Management Consultation Program, St. Joseph’s Health Care London, implemented a change management project to support Long-Term Care (LTC) homes with the implementation the Algorithm to assist health care providers to implement a plan of treatment for cardio-pulmonary resuscitation (CPR). This project had two phases. Phase I was a demonstration project in three sites of the Woodingford Lodge LTC homes in Oxford County. For Phase II, the SWHPCN received funding the South West Local Health Integration Network to implement this same process in two other organizations: the Tillsonburg District Memorial Hospital and the South West Community Care Access Centre (CCAC).  
 
Many of the resources developed in the project are displayed on this site for use by others whom may find them beneficial. Acknowledgements are provided to the organizations and individuals who supported the development of this material.  For information regarding details of the project, or the material provided on this site, please contact the Palliative Pain and Symptom Management Consultation Program of Southwestern Ontario, St. Joseph’s Health Care London at 519-685-4086.

 


E-learning Modules

This series of e-learning modules was designed to be part of a blended learning strategy. Modules 1 through 6 are designed to assist health care providers to:

  1. Understand the difference between Advance Care Planning (ACP) and Informed Consent for health care decision making as described in the Ontario Health Care Consent Act.
  2. Understand the elements of informed consent and how to apply them to discussions about Cardio-pulmonary Resuscitation (CPR).
  3. Understand the use of the algorithm as a tool to help guide the process for informed decision making.
  4. Gain the knowledge and skills to enhance discussions including the process for conflict resolution.

 

Module 7 is intended to assist members of the public to:

  1. Understand the purpose of Advance Care Planning (ACP) which includes the role of the Substitute Decision Maker as reflected in the Health Care Consent Act of Ontario.
  2. Understand the elements of consent in order to make an informed decision related to health care in various setting in the health care system.

 

Learners may participate in the learning independently by clicking on the link. Each module takes about 20-25 minutes to complete.

Module 1 Plan of Treatment for CPR
Module 2 Algorithm for Development of a Plan of Treatment for CPR
Module 3 Guide to Conversations
Module 4 Documenting
Module 5   Physician Overview
Module 6   The PSW's Role
Module 7.1   Introduction
Module 7.2   Information for Patients - Advance Care Planning
Module 7.3   Information for Families & Substitute Decision Maker(s)
Module 7.4 Information for Patients - Scheduled for Surgery
Module 7.5  Information to Patients - Admitted to Hospital


Educational Initiative Support Materials

This section is designed to provide resource material for the implementation of a ‘Plan of Treatment for CPR’ project in health care facilities/institutions. For specific downloadable resources, please refer to the “Resource Section” located in the upper right hand corner of each of the e-learning Modules.

Algorithm for Development of a Plan of Treatment related to CPR and Completion of the DNR Confirmation Form Algorithm
Algorithm for Conflict Resolution Regarding CPR Decisions Algorithm
Teaching Resource - SAMPLE Case Studies - Conversation Starters Teaching Resource - SAMPLE Case Studies
Communication Phrases Communication Phrases
SAMPLE Brochure - Don`t Be Surprised When We Ask SAMPLE Brochure
Frequently Asked Questions (FAQ) - for Developing a Plan of Treatment Related to CPR FAQ
Plan of Treatment for CPR - SAMPLE Quiz SAMPLE Quiz
Plan of Treatment for CPR - SAMPLE Quiz ANSWER KEY SAMPLE Quiz ANSWER KEY
Evaluation Focusing: Program Logic Model and Evaluation Framework Consent for CPR Project Final Evaluation


Implementation Support Materials – Do-It-Yourself Guide based on the Woodingford Lodges, Oxford County, Ontario Demonstration Project

This material is specific to the work done at the three demonstration sites of the Woodingford Lodge LTC homes in Oxford County, Ontario during phase I of the Plan of Treatment for CPR Initiative. For more information on this project, and practical ‘Do-it-Yourself Tips', please review the links below.

Section A: Intro to Do-it-Yourself Guide Section A
Section B: Primed for Change Section B
Section C: Blueprint Strategy Section C
Section D: Colourful Management of Change Strategy Section D
Section E: Educational Strategy with Curb Appeal Section E
Section F: Physicians on Board Strategy Section F
Section G: Before and After Evaluation Plan Section G

 

Demonstration Project Final Evaluation Report