Barwon Health's (BH) community sector has been the focus of the Respecting Patient Choices (RPC) program implementation as it was considered that treatment decisions were best made in the non-acute phase of a person's illness.
The initial aim was to provide advance care planning (ACP) for patients with chronic illness participating in formal programs including the Hospital Admission Risk Program (CHF & COPD clients), Renal Services, Palliative Care Services and Aged Care. The acute site wards where these patients were likely to be admitted were also included in the initial phase of implementation.
It became evident that as partners of patients and others in the community heard about the program, there were more individuals wanting to complete ACP's. This group of relatively well, ‘non-patients’ had a high completion rate of ACP documents (80%).
As a result, strong links have been established with the local General Practice Association, General Practices, private hospitals and other health service providers. A public launch was held to raise awareness and the service was extended to provide access to ACP for all BH patients and the wider community.
Process and systems are in place to provide follow up of patients post introduction, consultation, audit, electronic alerts and review. ACP documents are accessible to provide information to family and health care providers.
Data collection and IT capabilities at BH have been useful for both reporting requirements and to identify potential patients and areas requiring ongoing focus.
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