Abstract

Advance care planning (ACP), in its most sophisticated form, is a comprehensive, ongoing, and holistic communication between a physician and his or her patient (or the patient's designated proxy) about their values, treatment preferences, and goals of care. However, treatment decisions at the end-of-life are very complex, making comprehensive ACP extremely challenging. This presentation provides guidance and real-life examples for implementing ACP practices in local settings, summarising over 12 years of successful ACP and related clinical quality improvement work in the US with hundreds of health care professionals and social service providers across the gamut of service delivery silos. Key points covered in the presentation are ways to: target appropriate patients; embed ACP practices in busy healthcare settings; conduct rapid-cycle quality improvement activities, test ‘front-line’ ideas and successful practices in the daily care routine; and change the ‘usual’ healthcare delivery setting culture by making quality improvement and patient safety a top priority. Ensuring the centrality of the patient and family's voice in treatment decision-making is one of the most important goals for achieving patient/family-centred care. This workshop adds to the evidence base and demonstrates how QI can help improve ACP by using the PDSA cycle for clinical quality improvement in an effective, example-based presentation; focusing on the specifics of real-world clinical team experience, in a variety of health delivery settings; and providing a tested pragmatic approach to advance care planning.