Background In 2013 the Canterbury District Health Board (CDHB) commenced a programme of work to integrate ACP into the established health care structure.
Aim To integrate ACP into the established healthcare structure in the Canterbury region of New Zealand.
Methods A workstream was formed. Electronic templates created and systems established to allow an electronic advance care plan to be loaded and viewed across the primary and tertiary interface. Web based resources were developed and two ACP facilitators employed to help integrate the programme.
Results 151 electronic advance care plans have been published to date.
79% of plans are created in general practice, 6% in the hospital environment, 0% in ARC and 15% by other HCP.
59% of patients who have died with electronic Advance Care Plans, died in their preferred place of death.
ACP pages on the CDHB consumer health website are consistently ranked in the top 10 pages viewed.
Discussion ACP conversations and plans are becoming an increasingly valued part of the Canterbury healthcare structure supported by local mentoring, regional teleconferencing and national education programmes. Conversations are often initiated in the tertiary or ARC sector and culminating in plans completed in general practice.
The majority of patients with electronic Advance Care Plans are being supported to die in their preferred place of death.
Systems are enabling many of the plans to be generated without facilitator involvement helping to ensure sustainability of the ACP programme.
Conclusion Since initiation in 2013 the evidence suggests ACP has begun integrating into the established healthcare structure of Canterbury.
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