Facilitator and Referral models of advance care planning (ACP) provision
| Facilitator model of ACP | Referral model of ACP | |
| Description of model | Case managers are trained to facilitate ACP with their clients. They will conduct the ACP discussions and complete advance care directives (ACDs) (where appropriate). | ACP is conducted by an ACP facilitator at a specialist service located at public health services and use trained non-medical facilitators (usually nurses) to conduct ACP. Each service determines how their ACP facilitators are trained. ACP is provided free of charge. |
| Potential advantages | Case managers have ongoing relationships with clients. Case managers are part of the usual care team. ACP is conducted in the client’s home. | Clients have access to expert facilitators. Specific time is allocated for ACP. |
| Potential disadvantages | Case managers need to find time within current workloads and roles. Case managers may not be expert enough as ACP facilitators | Client needs to travel to appointments. Clients do not have existing relationships with facilitators. The facilitator is not part of the client’s usual care team. |
| Training provided | Three-module learning package (ACP theory, ethics/law, doing ACP) expected to take 2 hours to complete. This is completed prior to the an 8-hour (face-to-face) experiential workshop consisting of facilitated discussion and role play. The workshop’s primary focus is ‘how to have the conversation’. During the workshop, participants were expected to complete a full ACP discussion with another participant and document the outcome in an ACD. | Two-hour face-to-face training session, providing an overview of ACP, interactive training in initiation of ACP and instructions on how to refer clients and follow-up requirements for clients who attended an ACP service. |
ACD, advance care directive.