Locating advance care planning facilitators in general practice increases consumer participation

Area of Science:

• Healthcare Management
• Public Health
• Gerontology

Background:

• Advance care planning (ACP) is crucial for positive end-of-life care experiences.
• Low completion rates for ACPs remain a significant challenge in healthcare.
• Integrating ACP services into primary care settings is being explored to improve accessibility.

Purpose of the Study:

• To evaluate the impact of co-locating advance care planning (ACP) facilitators within general practices.
• To determine if this co-location model increases participation and completion of ACPs.
• To assess the effectiveness of point-of-care ACP assistance.

Main Methods:

• A quasi-experimental design comparing ACP program referrals and completion rates before and after co-locating facilitators in general practices.
• Trained ACP facilitators were integrated into 18 general practices from 2012 onwards.
• Data on referrals and completed ACPs were collected and analyzed from 2008 to 2015.

Main Results:

• Referrals to the ACP program increased substantially from 2520 (2008-11) to 6847 (2012-15).
• General practices with co-located facilitators generated 48% of referrals (2012-15), achieving a 93% ACP completion rate.
• Practices with co-located facilitators showed higher completion rates (93%) compared to those without (74%) and other sources (55%).

Conclusions:

• Co-locating ACP facilitators in general practice is an effective strategy to increase program engagement.
• This model significantly enhances the completion rates of advance care plans.
• Integrating ACP services at the point of care in primary settings improves end-of-life care planning.