Background BHS Residential Services has 454 resident beds over 10 facilities within the boundaries of the city of Ballarat, a large regional city in Victoria, Australia. In August 2010 Residential Services participated in a pilot program from the Respecting Patient Choices (RPC) department at Austin Hospital.

Since then we have built a program that involves:

• A dedicated Advance Care Co-ordinator

• A sustainable training program for ACP facilitators

• Use of ACP as part of the admission process with annual or review as required

Aim Every resident will be offered Advance Care Plan (ACP) in order to better meet their wishes for End of Life care.

Results

• 85% of residents have a current ACP in place

• 86% of residents had their documented wishes respected/met at time of death

Discussion/conclusion Key success factors and lessons to be discussed include:

• Executive support and ownership for the program

• Embedding the ACP work in a broader End of Life framework

• A dedicated resource, co-ordinate, evaluate and lead improvement

• Targeted training of key staff as facilitators

• Ensuring support programs for residents to die in place.

  • Residential In-Reach program for support with acute symptom and illness management plans and

  • Palliative Care team support