With COVID-19 at the forefront of everyone’s minds, the Shared Care Planning team has been exploring ways to encourage health care teams to have important conversations about medical decisions with their at risk patients.

These conversations are already happening and include discussion around resuscitation and goals of care, and the patient’s treatment goals and priorities.

Acute Plans document and share important clinical information, and assist health professionals working across the health system with decision making. It means that when a patient presents acutely unwell and cannot easily speak for themselves, the teams at the general practice, emergency department, urgent care and hospital can all see the important information included in the plan electronically.

People should consider having a plan if they are vulnerable and may present acutely unwell to emergency services and, in the current environment, those who are at risk of serious infections with Covid-19.

There is now a window of opportunity to document and share this knowledge of patients with acute services.

This information could include patient preferences and key medical decisions –

• unwanted and unwarranted treatment if their condition deteriorates, such as no resuscitation/ ventilation/ antibiotics etc;
• or critical information about vulnerability that a very ill or delirious patient might not be able to communicate for themselves. For example,
  - brittle/ severe asthma which is likely to need a more urgent response than may be apparent;
  - mental health or social issues which could affect how a person seeks help and their response to treatment;
  - community supports which might allow a patient to be managed at home rather than admitted to hospital.

Creating an Acute Plan is free for the patient and now is an opportune time for general practices to talk to their patients about making one.

In the current crisis, conversations about unwanted or unwarranted treatments if their condition deteriorates, are being prioritised. These people may already have had these conversations with their whānau and health care team and made enduring decisions.

If you work in a general practice and you would like to find out more go to the CCN or Healthpathways websites.

For the general public wanting to know more, there is a brochure, which has recently been developed about shared care plans. This is available on the CCN website. You can also search for shared care plans on healthinfo.org.nz