16 Using normalization process theory to assess integration of the serious illness care program

Advance care planning is known to have significant positive outcomes for people living with serious illness.¹ The Serious Illness Care Program (SICP) is a care delivery model aimed at improving communication skills around serious illness . The North East Collaboration of The Northern Palliative Care Academy (NPCA) have implemented the SICP within the Northumbria Healthcare Trust Colorectal Surgical and Palliative Teams. The Normalisation MeAsure Development questionnaire (NOMAD) comprises 3 questions on a 10-point scale and 20 questions on a 5-point scale, exploring factors affecting the implementation of complex healthcare interventions into clinical practice. We surveyed 10 clinicians across both teams prior to receiving SICP training and at 6 months post-training. We reviewed the implementation of SICP by comparing mean survey responses. Our results demonstrate that 6 months post-training there was an improvement in both familiarity with using the SICP (3.6 to 5.5 out of 10) and normalisation of the tool into clinical practice (4.2 to 5.7 out of 10). Importantly, positive responses to all other questions were maintained throughout the 6-month period. The SICP has been effectively implemented into our clinical teams, demonstrated with the use of the NOMAD tool. We suggest that other teams may find the NOMAD tool useful in assessing the implementation of the SICP into multi-speciality teams. References Wright AA, Mack JW, Kritek PA, et al. Influence of patients' preferences and treatment site on cancer patients' end-of-life care. Cancer 2010;116:4656–63. doi:10.1002/cncr.25217. Detering KM, Hancock AD, Reade MC, et al. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ 2010;340:c1345. doi:10.1136/bmj.c1345. Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733–42. doi:10.1056/NEJMoa1000678 https://www.ariadnelabs.org/wp-content/uploads/2017/05/SI-CG-2017-04-21_FINAL.pdf