1282 Development of the paediatric advance care planning tool, paediatric statement of choices (PSOC)

<h3>Aim</h3> To develop and evaluate a clinical tool and form that would allow best practice ACP for children. <h3>Background</h3> Advance Care Planning (ACP) is the process of planning for both current and future health care. It involves consideration of values, beliefs and preference of the patient with their family and health professionals. There is increasing acknowledgement of the role of ACP within paediatrics. A collaborative and interdisciplinary committee was formed to assess forms used in other jurisdictions, and to determine what would work best in one state of Australia. This form has been subsequently finalised and endorsed as a statewide form. Cultural considerations have also been incorporated into the form. <h3>Methods</h3> Parents who completed the form were sent a survey to complete. The sample size is 10 parents. Parents were able to rate how helpful each of the Choices offered by the tool in a 5-item scale ranging from very unhelpful to helpful. Other survey questions related to the timing of introduction of the PSOC and who initiate the conversation. Thematic analysis of the values statements provided by parents was undertaken. <h3>Results</h3> Preliminary results include positive feedback from parents. One father said: ‘I like that we are able to write a statement of choice, when we feel comfortable to write it’. Most participants felt the timing of introduction of the tool was ‘just right’ with clinicians initiating the discussion 50% of the time. Parents felt that signing of the form should be optional, which is in keeping with the form not being legally binding. Themes expressed in the PSOC include the importance of family and spiritual considerations. <h3>Discussion</h3> Development of the pilot form and tool has been well received from parents who have used the tool. It is important to utilise ACP discussions and associated tools for patients who have an open-ness to use such tools. <h3>Unique Contribution</h3> This tool focuses specifically on children and allows for developmental considerations in how goal and wishes related to ACP are captured. Specific considerations for patients from Aboriginal and Torres Strait Islander backgrounds are also incorporated into the document. <h3>Implications</h3> The PSOC provides a structure and scaffolding that can prompt a series of conversations related to a child’s life limiting illness. The tool not only can prompt discussion but also provides a format that can be captured in the electronic medical records. This can assist both family and clinicians especially after hours.