EP.TU.270Improving Treatment Escalation Plan (TEP) Completion Rate for General Surgical Patients

Aims Treatment Escalation Plan (TEP) is essential for recognition of patients’ ceiling for care in the event of clinical deterioration. It should be clearly documented to ensure continuity of care, especially during Covid-19 pandemic. This audit aims to evaluate and improve the TEP filling rate for general surgical patients. Methods A prospective data collection was performed for one week in July 2020 in general surgical wards. Data on patients’ gender, age, presence of DNACPR form and date of TEP completion were collected from patients’ clinical notes. Data was analysed using SPSS statistic software. Educational posters were displayed in the ward and presentation was done to emphasise the importance of TEP documentation. Second audit cycle was done in August 2020 to assess for improvement in TEP filling rate. Results In the first cycle, 60 patients were included with a mean age of 60. Only 11.7% patients had TEP form filled in with a mean delay of 2.7 days since admission. In the second cycle, 57 patients were included with a mean age of 66. 28.1% patients had TEP form documented with a mean delay of 1.7 days. This has shown a 140% improvement in completion rate of TEP form and 59% reduction in the delay in TEP documentation. Conclusions TEP is essential to ensure that patients received optimal care when their condition deteriorate. Simple intervention such as educational posters will help to improve the TEP completion rate. However, continuous auditing is required to ensure improvement in TEP documentation for surgical patients.