TY - JOUR T1 - Handing over the reins – establishing long term strategies for embedding advance care planning in rural and remote communities in Australia JF - BMJ Supportive & Palliative Care JO - BMJ Support Palliat Care SP - 75 LP - 75 DO - 10.1136/bmjspcare-2011-000053.33 VL - 1 IS - 1 AU - C Ashley Y1 - 2011/06/01 UR - http://spcare.bmj.com/content/1/1/75.2.abstract N2 - Establishing effective advance care planning (ACP) implementation programs in communities is challenging at the best of times – but when the region extends to over 166 000 square kilometres of rural and remote country, and human resources are limited, strategies need to have the ‘wow’ factor in order to ensure sustainability. In 2009, a project to introduce ACP was set up in southern NSW as part of a state wide approach. Since that time, much has happened, including structural reform at state level resulting in changes in regional boundaries, cessation of funding for the continuation of the project and the worst floods in 70 years! In order to ensure the sustainability of the program, the last year has seen a shift from ‘implementation’ of ACP to a ‘handing over the reins’ approach. Various activities have been introduced to consolidate ACP at a local level. These have included working with health managers to embed ACP in quality improvement and risk management activities, creating links with local divisions of general practice and with community groups, working with staff and residents in aged care facilities, establishing a range of accessible resources for health professionals, and passing on responsibility for education to local educators and clinicians. The presentation will demonstrate that evidence is mounting regarding the effectiveness of these strategies in moving ACP from ‘project’ status to being embedded as an important component in ensuring effective health delivery. ER -