Background The Snohomish County Health Leadership Coalition is a countywide collaborative among business, healthcare, social service, and faith organisations with the shared goal of improving healthcare value and quality. We sponsor an ACP initiative that engages these sectors to educate, empower, and inspire both citizens and medical staff to initiate conversations about end of life care, to document these conversations, and to honour these documents.

Aim Our aim is that 80% of our citizens at the time of death will have advance directives in their medical records by 2030.

Methods Respecting Choices is the primary curriculum with volunteer facilitators hosting public classes in community centres, healthcare facilities, and businesses. Six Steps and Your Life, Your Wishes are local curriculums also used for public education. Medical staff receive training through the Compassionate Care program. Our public courses are adapted for ethnic-specific and homeless communities.

Results Since its inception in 2012, the Initiative has educated 1,318 citizens/177 medical staff. Our 2015 goal is 1,500/130, our 2016 goal is 3,000/130 and our 2017 goal is 4,500/130.

Discussion Collective impact is the harnessing of cross-sector leadership and resources to achieve critical goals and SHCLC is applying this strategy to Advance Care Planning. The unique attributes of this approach can lead to long-term sustainability and broad replication.

Conclusion The collective impact strategy in promoting regional advance care planning is relatively unique and we trust that practitioners, researchers and policy makers worldwide will gain insights on how to regionally develop, implement and improve advance care planning.