Background Implementation of ACP in Singapore has been ongoing since 2010. Most ACP discussions are conducted in acute hospitals and facilitated by trained healthcare workers (ACP Facilitators). However, low public awareness of ACP has hampered patient recruitment efforts. A training programme was developed to enable non-Facilitators to aid in outreach and patient education efforts.

Aim Recruit and train advocates to promote and share ACP resources in the community through word-of-mouth and empowerment, Prime patients for the facilitated ACP discussion and provide referrals to Facilitators

Methods

1. Garner feedback from Facilitators on key impediments to patients’ unwillingness to do ACP

2. Acknowledge the need to train advocates to improve accessibility of ACP

3. Tailor training curriculum to ensure acquisition of ACP knowledge, skills, and aptitude to effectively campaign and mobilise support in the community

4. Build effective partnerships with healthcare service providers to organise workshops

5. Gather feedback continually to improve the programme

Results Workshops are currently offered at two large public hospitals and by request in the community. Over 700 individuals have been trained.

Discussion Trainees require ongoing support to remain engaged as ACP Advocates. Resource-strapped organisations could leverage on a broader base of volunteer Advocates to support and channel willing patients to a core group of Facilitators.

Conclusion ACP Advocacy is a widely accessible and highly customizable training framework that enables greater participation among non-clinical staff and laypersons in ACP outreach. Further research needs to be done to establish the correlation between advocacy and the uptake of facilitated ACP discussions.