Background The development of a systematised advanced care planning process in Catholic faith based institutions has presented challenges that have seen unsustainable unsupported programme. Increasing clinician need, a changing understanding of the role of advanced care planning in routine health care, changing community expectations of the use of advanced care plans and reform in health care quality standards have necessitated a recommitment to develop a sustainable, workable process.

Aim To present a narrative of the factors, internal and external to the hospital, that have had to be considered and worked through, to develop a programme in care planning for advanced care at St. Vincent's Hospital Melbourne that has gained acceptance and led to implementation to be embarked upon.

Methods Review of the Advanced care planning working group's meeting minutes actions and document developments taken over 8 month period June 1 to December 2.

Results The process demonstrates the key steps in the 18 month timeline that has brought significant points of development to create a workable and viable policy and guidelines, acceptable within a Catholic hospital's ethical and clinical framework

Discussion Sharing the learning's will be helpful for others developing programmes in comparable institutions to see how important the linking together of key people and committees in an organisation is to develop the acceptable shared understanding and language within the institutions ethical and clinical framework.

Conclusion Setting aside historical challenges, it has been possible to develop a system of advanced care planning processes within a Catholic, faith base, tertiary hospital.