Defining Advance Care Planning and Identifying Quality Indicators: A Case Study on Key Stakeholders' Perspectives in...

In recent years, several regions have evolved their own definitions of advance care planning (ACP). Country-specific characteristics may affect local definitions, goals, and quality assessment.

To obtain collective views of key opinion leaders in Singapore regarding the target population, scope, and goals of ACP, and to propose a list of quality indicators that could be used to monitor and evaluate its progress and impact.

A World Café methodology was used to facilitate group discussions among participants involved in ACP-related work across a range of settings including acute hospitals, community hospitals, primary care clinics, nursing homes, community care organizations, nursing homes, and universities. To define the target population, scope, and goals of ACP, three distinct exercises were conducted within the World Café session, from which main insights were synthesized and reported.

A total of 34 ACP leaders, administrators, facilitators, and researchers representing 25 organizations participated. ACP was conceived to be an ongoing process of exploring an individual's personal beliefs, values, and health care preferences in relation to current and future medical care, together with their families and loved ones. To balance respecting the voice of the individual a with operational efficiency, organizations can deploy structural and process quality indicators to guide goal achievement.

We have established the intended target population, scope, and goals necessary to inform the implementation of ACP. Critical quality indicators were identified to support the monitoring and evaluation of the program's progress across different implementation stages in Singapore.