Implementing ReSPECT during the pandemic – our experience and lessons learnt

IntroductionReSPECT was implemented in The Royal Wolverhampton NHS Trust and across the wider Wolverhampton health economy on 1st September 2021. This was the culmination of a year's planning and preparations during the first and second waves of the COVID pandemic.MethodsA ReSPECT implementation group was established across the organisation in September 2020 which focused on areas including writing a revised resuscitation policy, agreement for and design of one-off mandatory modules for awareness and authorship training and development of a trust wide communications campaign. Amendments to the policy have allowed expansion of authorship to selected groups of non-medical staff including senior specialist nurses and ACPs with appropriate expertise.The group liaised with partners to ensure a successful city-wide launch including primary care and hospice colleagues. An organisation wide roll out was supported by ward ‘ReSPECT Champions' in each area.Results and Lessons Since LaunchMandatory training modules for ReSPECT authorship and awareness training were developed for approximately 7000 clinically facing staff with a target of 75% training compliance prior to launch. Training compliance was monitored weekly in preparation for launch and then subsequently, monitored monthly once target compliance was achieved. Over the last year ReSPECT has become embedded within the organisation and across the city. This has included a change in culture from the previously used DNACPR forms. Developments following launch include an addition to e-discharge document to include whether a ReSPECT form is in place and from this a monthly quantitative audit has begun across inpatient areas. Collaborative working has continued across the city to enable clear communication regarding ReSPECT and shared resources e.g., Top tips newsletters. Future ongoing work focusses on improving the quality of ReSPECT forms and education surrounding the ongoing review of ReSPECT forms during acute admissions and at significant milestones in a patient's condition.