Integrating palliative care into practice—part three: heart failure professionals’perceptions of using the ‘what matters’ meaningful conversation plan

Background/Aims A 2018 national enquiry influenced the design, development and implementation of the cardiac supportive palliative care resource framework, including the ‘what matters’ meaningful conversation plan (WMMCP), to improve future care planning conversations for people with heart failure. This article, the third in a three‑part series, describes an evaluation of heart failure professionals’ perceptions and experiences of using the WMMCP in routine clinical practice in the UK and Ireland. Methods A total of 23 heart failure services participated in the evaluation. Heart failure professionals in each service used the WMMCP in routine consultations with up to 10 patients and/or carers during a 3‑month period. They then completed a 20‑item questionnaire developed by the authors to describe their experience. Section one of the questionnaire related to the use of the WMMCP in initial consultations, while section two related to follow ups. After a 3‑month period, participating services and/or heart failure professionals completed a second, 22‑item questionnaire about their overall experience of using the WMMCP in routine practice. A combination of multiple‑choice and open questions were used. Multiple‑choice responses were analysed using descriptive statistics, while responses to the open questions were analysed using thematic analysis. Results Responses indicated that use of the WMMCP in routine practice led to an increase in future care planning conversations, especially at the earlier stages of the disease trajectory. Respondents reported that use of the plan had led to a change in their clinical practice and most felt comfortable having these conversations with patients and carers. The need for training on how to use the WMMCP and information related to financial support and power of attorney were noted. Conclusions The WMMCP was found to be a useful tool in routine clinical practice in heart failure services, providing a supportive framework for the delivery of person‑centred care across the inherently uncertain heart failure disease trajectory. The findings of this evaluation have been used to inform an improved second version of the WMMCP, which is available to health professionals.