Oral Presentation Palliative Care Nurses Australia Conference 2022

Supporting Advance Care Planning in Queensland (#51)

Leanne Clemesha 1 , Leyton Miller 1 , Liz Reymond 2 3
  1. Statewide Office of Advance Care Planning, Queensland Health, Eight Mile Plains, Qld, Australia
  2. Metro South Palliative Care Service, Queensland Health, Eight Mile Plains, Qld, Australia
  3. School of Medicine, Griffith University, Gold Coast, Qld, Australia

Background:

Advance care planning (ACP) is central to quality end-of-life care. Queensland Health (QH) recognises people are not dying as they wish, and a standardised ‘system’ is needed to promote iterative ACP; and provide real-time access to quality ACP documentation across service settings.

Aim:

To support a unified system of ACP and end-of-life care that facilitates patient-centred, high-value care by strengthening the capacity of clinicians to respond efficiently and effectively to the end-of-life care needs of Queenslanders.

Methods:

The ‘system’ is supported by:

  • State-wide digital infrastructure
  • The State-wide Office of Advance Care Planning ([SOACP] recurrently funded) and ACP facilitators
  • QH funding incentives for Hospital and Health Services (HHS) ACP activity
  • Educational resources.

Findings:

As of January 2022, the SOACP has received and reviewed 95,313 ACP documents from individuals, acute, community and residential aged care settings.

77,238 effective documents are now uploaded to individuals’ QH electronic hospital records in the ACP Tracker (in The Viewer), ordered by document date and name, and accessible by authorised users in all QH hospitals and AHPRA-registered doctors, nurses/midwives and paramedics (via the Health Provider Portal). Awareness and access of the ACP Tracker is growing. In 2020-21, there were 1,136,143 launches (by a range of staff disciplines) and 39,911 ACP Tracker comments (linked to HHS ACP activity funding).  

Senders are advised of issues when documents do not meet criteria for upload and provided with options to remedy issues. In 2020-21, 24% (766) of ineffective ACP documents were returned as effective.

Discussion:

Queensland is the first jurisdiction to have a state-wide system to receive, review, upload and access ACP documents. This unique system is supporting achievement of National Quality Standards related to ACP.

Ongoing funding for ACP facilitators, establishment of capability to upload Acute Resuscitation Plans to the ACP Tracker and digital linking of The Viewer with My Health Record will further enhance this ‘system’ providing a single ‘source of truth’ to inform patient-centred end-of-life care.

Conclusion:

The ACP system implemented in Queensland—inclusive of infrastructure, services and educational resources is facilitating patient-centred, high-value care and supporting helping health services to meet ACP related accreditation standards.

Funding acknowledgement:

Queensland Health.