Background The Victorian Advance Care Planning Strategy 2014–2018 (the Strategy) was launched in March 2014.

The Strategy aimed to ensure all Victorians have the opportunity to express their preferences for future treatment and care and provided a clear framework Victorian public health services. The strategy set out four priority actions:

Enabling the person;

Increasing workforce capacity;

Establishing robust organisational systems; and

Ensuring an evidence base and quality approach.

Methods A benchmarking survey was conducted in 2014 and a summative survey in 2018.

The surveys used the on-line survey administration tool - Survey Monkey (www.surveymonkey.com) with approximately forty questions across the four priority action areas.

Chief Executive Officers (CEO) at 84 publicly funded health services were contacted and asked to nominate one person from their health service, preferably with advance care planning experience, to complete the survey. There was over a 90% response rate.

Results Survey results found: significant increase in advance care planning programs; strong and increasing level of health services’ executive support; an increase in the use of advance care planning alerts in clinical data; increasing advance care planning education; and organisational practice and policy improvements.

Conclusion The results have confirmed the importance of a state-wide strategy and the development of state-wide resources such as an advance care directive form template and the development of a common advance care planning barcode. This paper will explore the progress being made in public health services and identify the lessons learned, gaps and challenges for future policy development.