Advance care planning: It matters to all of us

More than 980,000 people live in South Eastern Sydney Local Health District (SESLHD). This number is estimated to grow to more than one million by 2031, with more than 30% of the population over 70 years of age.¹ When advance care planning (ACP) is not undertaken, a person may receive treatment that is not in-line with their preferences or values. This is a contradiction to person-centred care and can result in an increased burden on families and healthcare providers, as well as increased costs for the healthcare system through the delivery of unwanted treatments.²

ACP involves planning for future health care.³ It is the process of a person deciding what care they would prefer should they become unable to make or communicate their decisions about their care.⁴ ACP is known as a three-part process that can take place across a person’s life, starting with a conversation, followed by the documentation of the preferences and decisions, and ending with it being accessed and enacted to guide treatment and care delivery.⁵

A collaborative and co-design approach

The objectives of this project are to improve the reliability of the ACP process across SESLHD, improve person-centred care and experiences, increase staff access to information, and to optimise the allocation of health resources by the end-of-life by December, 2024. Extensive consultation has been undertaken with stakeholders across SESLHD, from the ward to senior management, to adopt a co-design approach and prioritise solutions. A total of five solutions have been identified:

• The development of an ACP webpage will provide consistent information to SESLHD clinicians, to support increased understanding, knowledge and capacity building in ACP.
• The inclusion of ACP resources on MedApp™ will provide clinicians with an offline-accessible, mobile-first tool for easy access to clinical and hospital procedures around ACP, improve communication between clinicians and facilitate uptake of education and training opportunities.
• The revision and translation of the SESLHD ACP guideline into a SESLHD procedure will clarify the roles and responsibilities of SESLHD clinicians and administration staff. It will standardise components of the APC process and will provide a quick reference guide to address frequently asked questions.
• The development of a calendar of events to promote ACP will increase the profile and promotion of ACP initiatives across SESLHD throughout the year for healthcare staff and consumers.
• The development of a district-wide key performance indicator to monitor the reliability of the ACP process and keep APC on the ‘agenda’ for managers and leaders.

These solutions are scheduled for implementation or have already been implemented, with monitoring underway. The webpage is scheduled for go live in December 2023. Resources on Med App™ have been implemented for use by clinical staff across SESLHD. Review and translation of the ACP guideline is set to commence November 2023, with the calendar of APC promotional events to commence March 2024.

View this project's poster from the Centre for Healthcare Redesign graduation December 2023.

References