Clinical Order Articulating Scope of Treatment (COAST)
In the past decade, the New Zealand Ministry of Health, the District Health Boards, and community health care providers have been developing and promoting advance care planning. Advance care planning, or ACP, is important for all patients, as it provides individuals with the opportunity to think about and express treatment preferences based on personal beliefs and values, current and anticipated medical conditions and care needs, and available treatment and care options.
Currently in New Zealand, there are many different ACP documents and forms being used, and there is no one document that is recognised, easily accessed, and honoured across all care settings. Also, not all patients have an ACP or are able to do an ACP.
This pilot project involves developing and implementing a concise one-page medical order that can be used to provide appropriate goal-directed care for Southern District Health Board (SDHB) patients who reside in Southland and who have serious medical illnesses or frailty with an expected prognosis of one year or less. This document is titled Clinical Order Articulating Scope of Treatment (known colloquially as a “COAST form”).
The form has “Huarahi Rangimārie” written on it, a Māori term which translates to “Peaceful Path”.
Once completed and signed by the treating doctor or nurse practitioner, this document would be accessible to and accepted by all health care providers in Southland.
We have been collecting demographic data on patients who have COAST forms, and data on the number of hospitalisations in the 12 months prior to and following completion of the form. Our hope is that COAST will reduce unnecessary hospitalisations and goal-discordant care in the final year of life. We also aim to ensure that the form is acceptable to patients, families, and health providers by asking them to complete a survey to provide feedback on the form and the process.
Currently in New Zealand, there are many different ACP documents and forms being used, and there is no one document that is recognised, easily accessed, and honoured across all care settings. Also, not all patients have an ACP or are able to do an ACP.
This pilot project involves developing and implementing a concise one-page medical order that can be used to provide appropriate goal-directed care for Southern District Health Board (SDHB) patients who reside in Southland and who have serious medical illnesses or frailty with an expected prognosis of one year or less. This document is titled Clinical Order Articulating Scope of Treatment (known colloquially as a “COAST form”).
The form has “Huarahi Rangimārie” written on it, a Māori term which translates to “Peaceful Path”.
Once completed and signed by the treating doctor or nurse practitioner, this document would be accessible to and accepted by all health care providers in Southland.
We have been collecting demographic data on patients who have COAST forms, and data on the number of hospitalisations in the 12 months prior to and following completion of the form. Our hope is that COAST will reduce unnecessary hospitalisations and goal-discordant care in the final year of life. We also aim to ensure that the form is acceptable to patients, families, and health providers by asking them to complete a survey to provide feedback on the form and the process.
Further information
For further information and frequently asked questions click on the links below, or at the top of the page.
If you have any questions or concerns please contact:
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Hospice Southland, 75 Kew Road, Invercargill, 9810
Telephone: 0800 211 308 E-mail: [email protected] |
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