Developing a Decision-Making Capacity Assessment Clinical Pathway for Use in Primary Care: a Qualitative Exploratory Case Study

Authors

  • Lesley Charles University of Alberta
  • Jacqueline MI Torti Western University
  • Suzette Brémault-Phillips University of Alberta
  • Bonnie Dobbs University of Alberta
  • Peter GJ Tian University of Alberta http://orcid.org/0000-0003-0682-082X
  • Sheny Khera University of Alberta
  • Marjan Abbasi University of Alberta
  • Karenn Chan University of Alberta
  • Frances Carr University of Alberta
  • Jasneet Parmar University of Alberta

DOI:

https://doi.org/10.5770/cgj.24.400

Keywords:

Decision Making Capacity Assessment, primary care, clinical pathway

Abstract

Background

With an ageing population, the incidence of dementia will in­crease, as will the number of persons requiring decision-making capacity assessments. For over 10 years, we have trained family physicians in conducting decision-making capacity assessments. Physician feedback post-training, however, has highlighted the need to integrate the decision-making capacity assessment process into the primary care context. The purpose of this study was to develop a decision-making capacity as­sessment clinical pathway for implementation in primary care.

Methods

A qualitative exploratory case-study design was used to ob­tain participants’ perspectives regarding the utility of a visual algorithm detailing a decision-making capacity assessment clinical pathway for use in primary care. Three focus groups were conducted with family physicians (n=4) and allied health professionals (n=6) in two primary care clinics in Alberta. A revised algorithm was developed based on their feedback.

Results

In the focus groups, participants identified inconsistencies and a lack of standardization regarding decision-making capacity assessments within primary care, and provided feedback regarding a decision-making capacity assessment clinical pathway to make it more applicable to primary care. Participants described this pathway as appealing and straight­forward; they also made suggestions to make it more primary care-centric. Participants indicated that the presented pathway would improve teamwork and standardization of decision-making capacity assessments within primary care.

Conclusions

Use of a decision-making capacity assessment clinical path­way has the potential to standardize decision-making capacity assessment processes in primary care, and support least in­trusive and least restrictive patient outcomes for community-dwelling older adults.

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Published

2021-02-18

How to Cite

1.
Charles L, Torti JM, Brémault-Phillips S, Dobbs B, Tian PG, Khera S, Abbasi M, Chan K, Carr F, Parmar J. Developing a Decision-Making Capacity Assessment Clinical Pathway for Use in Primary Care: a Qualitative Exploratory Case Study. Can Geriatr J [Internet]. 2021 Feb. 18 [cited 2022 Nov. 26];24(1):26-35. Available from: https://cgjonline.ca/index.php/cgj/article/view/400

Issue

Section

Original Research