Shared Goals of Care (SGOC) is a process of shared decision making that involves the patient, their whaanau (family) and clinicians. It ensures treatment options are aligned to patients‘ values and achieves clarity and agreement on the goal of care should the patient deteriorate during that episodes of care.

Te Whatu Ora Counties Manukau, a large metropolitan based in Auckland, formed a project team in 2020 aimed at implementing the SGOC process organisation wide. The aim was to provide a single source of truth via an electronic health record that records both a discussion and decision for an episode of care. This replaced a number of different documents including the existing resuscitation form with an e-SGOC form and was supported by a comprehensive training programme to all clinicians.

The presentation will outline the experiences of the project team during implementation and the real life difficulties in achieving behavioural change amongst clinicians. Acknowledging the different needs of patients versus clinicians, we will provide a detailed discussion of the insights gained and learnings achieved on the barriers and facilitators relevant to producing a change in the practice culture within complex health environments. The importance of cultural responsiveness to the local population will also be highlighted as well as adapting to recent stressors including COVID and other macro-level challenges.