Team Leads: Heather Kilgour     Principle Investigators: Dr. Leah Lambert, Ruby Gidda      Project Contact: Lilia Laihem    

The project was funded by BC Nurses' Union (BCNU), Michael Smith Health Research BC part of the REACH program grant, and BC Cancer Foundation.

Purpose: Our Knowledge Mobilization (KMb) project aims to rapidly mobilize recent nursing-led research conducted in BC to inform a nursing practice change that better support for oncology nurses in conducting Advanced Care Planning (ACP) across BC Cancer.

Outcomes

Ensure nurses have the opportunity to directly influence their standard practices related to ACP, facilitating the uptake of the new ACP nursing workflow to better support oncology nurses to conduct ACP.  Create a pathway from issue identification in the practice setting, to local research and data collection, to rapidly mobilizing findings to inform practice and improve patient outcomes.  Improve patient access to ACP, ensuring patients with cancer have the opportunity to reflect on their values and beliefs towards care, and use this information to inform their care decisions throughout their cancer care. 

Phase 1: Define Scope of Problem and Team Formation

In Phase 1, we established an ACP Nursing Working Group consisting of nursing researchers, direct care nurses, patient and family partners, nursing leaders, clinical nurse specialists, and members of the BC Centre for Palliative Care.

The working group reviewed evidence on best practices for ACP, identified current ACP tools and resources, and gathered evidence about current practices from our local contexts. 

 

Phase 2: Developing and Testing Solutions

In Phase 2 working group members collaborated to co-create a new standard nursing workflow that better supports oncology nurses to engage in ACP, is acceptable and feasible within nursing practice, and support patients through the ACP process.

 

Phase 3: Provincial Implementation, Evaluation, and Sustainability

In Phase 3, the practice change will be implemented across all 6 regional cancer centres. Following implementation, we will evaluate the impact of the practice change and develop a sustainability plan to ensure long-term effectiveness. 

Work Up To Date

  • Created nurse-facing and patient-facing education materials (educational toolkit and resources, slide decks) and have updated the BC Cancer website, specifically the ACP Healthcare provider webpage,  ACP for patients webpage, and the professional practice nursing webpage.
  • Finalizing the implementation of nursing education (nursing orientation, education in huddles, ACP education sessions).
  • Piloting the new nursing standard practice and accompanying implementation toolkit in Surrey, Vancouver, and Abbotsford.

Next Steps

  • Scale the practice change provincially.
  • Evaluate the impact of the change through a post-implementation survey and chart audits.
  • Transition the implementation to Professional practice nursing to create structures to support sustainability of the practice change.

Resources

ResourcesDetails of ResourcesLink
ACP Flyer 
  • ACP Flyer to be given during first patient appointments.
  • Introduces and normalizes ACP.
  • Includes 4 reasons to talk to your healthcare team about ACP.
Educational Tool
  • To support ACP patient education, this is a 3-page resource that provides an overview of ACP.
  • Includes defining advance care planning, substitute decision makers, and options for recording wishes such as advance directives or letters to family.
ACP Lanyard
  • This lanyard card provides a script for introducing ACP and 4 questions to begin ACP conversations. 
ACP Conversation Guide
  • 1 Page ACP Conversation guide with probes to support a conversation between healthcare providers and a patient during early ACP conversations.
ACP Video
  • ACP nurse-facing video demonstrating the importance of ACP on patient care. 

In Fall 2024, we had the opportunity to share our insights through various conferences:

All Together – BC Centre for Palliative Care Symposium – October 4, 2024

Session title: Reimagining Advance Care Planning at BC Cancer: Results of a Nursing-led Knowledge Mobilization Project

Canadian Association of Nurses in Oncology (CANO) Annual Conference – October 24-27  

Abstract 1: Advance care planning in oncology nursing: Developing the tools, resources, and environments for nursing-led advance care planning

Abstract 2: Translating knowledge to practice: Improving advance care planning practices through embedded knowledge mobilization

BC Cancer Summit – November 21-23  

Session title: Advance Care Planning Essentials: Equipping Healthcare Providers to Facilitate Meaningful Conversations.

Putting Patients First – BC SUPPORT Unit – November 14  

Poster Presentation: Co-Creating Care: Enhancing Advance Care Planning in Oncology Through Patient & Healthcare Provider Partnerships

Learn More

Read more about the Advance Care Planning Research -> ACP Research

If you’re interested in learning more about this project please contact Heather Kilgour at heather.kilgour@bccancer.bc.ca.

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