Objectives Advance care planning (ACP) is the process of documenting a person’s preference for medical treatment in the event of future deterioration. This audit aimed to improve discussion and documentation of ACP in patients who die during a hospital admission.
Methods We performed a clinical audit in 2021 of inpatients at a tertiary hospital in Sydney, Australia to evaluate the benefit of multimodal interventions to improve ACP compared with previous audits from 2016 and 2011.
Results In 2021, 97% of audited patients had a documented ACP prior to death compared with 80% in the 2016 audit. The completion of NFR documentation on admission in 2016 was 33%, while in 2021 65% of ACPs were completed within 24 hours of admission.
In 2021, 94% of patients had a paper resuscitation form filled; however, identification stickers, which are associated with risk of error, were used in 64%; and 25% of forms were only partially completed. Palliative care was consulted for 44% of patients prior to death; 33% on the day of or prior to death.
Conclusions Improvement in prevalence and timing of ACP prior to death is seen in the postintervention audit. A repeat audit in 5 years will be conducted, with interventions focused on improving documentation of ACP.
- Advance Care Planning
- Hospital care
- Advance Directives
- Education and training
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Contributors SS: conception and design, analysis and interpretation of data, drafting and revising article. AA: conception and design, analysis and interpretation of data, drafting and revising article. SM: data collection, analysis and interpretation of data. JH: data collection, analysis and interpretation of data. CG: conception and design. JTL: conception and design, drafting and revising article, supervison of project. GA: conception and design, drafting and revising article, supervision of project
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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