Background Woodlands Health is a new integrated hospital planned to be opened in 2024. It’s staff are currently nested in various hospitals in Singapore including within 4 acute general medical wards in Yishun Campus. These wards look after more than 400 patients per month in approximately 130 beds. Regular Advance Care Planning (ACP) training was conducted for physicians, medical social workers and nurses working within these wards in the last one year, however, the number of ACP completed within the wards remains very low. The objective of this quality improvement project is to build a culture of ACP within these wards and improve the rate of completion of ACP.

Methodology Meetings were held with the relevant stakeholders, including leads from nursing, general medicine and social work to understand barriers and needs, including feedback regarding current workflows in ACP and brainstorming on possible interventions. Workflows were simplified and consolidated based on feedback. A baseline survey of the knowledge of and attitudes towards ACP of the healthcare professionals will be conducted to understand prevailing perceptions and attitudes towards ACP. Best practices from general medicine of another hospital were shared. Outreach sessions to healthcare professionals and screening triggers for clinicians to initiate ACP are planned. Ongoing review of the project applying principles of quality improvement will take place.

Results The results of the survey, specific interventions of this quality improvement project as well as the changes in rate of ACP, if any, will be shared.

Conclusion Continual engagement of relevant stakeholders and multifaceted interventions targeting priority areas are important to build a culture of ACP and person-centred care.