Background Advance Care Planning (ACP) is an approach to achieving patient-centred decision making, which is a recognised mechanism for improving value, and improving a range of health outcomes. Whilst ACP has begun to gain momentum in New Zealand, there remains potential for further impact through systematic implementation.

Aim To identify the key success factors and barriers to implementation of ACP and make recommendations on policy and strategic approaches to achieve sustainable implementation of ACP at scale.

Methods A case study approach forms the principal method of inquiry. Four leading US organisations were selected based on; literature review; advice from key informants and selection criteria. Site visits, and in-depth interviews with a range of clinical and managerial staff were undertaken.

Results The research is scheduled for completion in August 2015. Expected outcomes include the importance of a systems approach encompassing; public education and engagement; professional development; decision support aids; availability of appropriate service provision (palliative/hospice care); aligned policy and funding systems. A deliberate change management strategy to support these elements is anticipated to be a key factor for success.

Discussion The recommendations from the research are expected to be of significance to a range of stakeholders. New Zealand has policy settings which recognise the importance of patient-centred care. Full realisation of the benefits has not been achieved to date.

Conclusion Effective implementation of ACP on a national scale requires a systems approach, incorporating a range of key elements. Success is dependent on a deliberate change management strategy.