23 Building capacity and capability in general practice to implement ACP in routine health assessments

<h3>Aim or Purpose</h3> To develop a consistent approach to the implementation of advance care planning (ACP) in routine health assessments in general practice. <h3>Background</h3> It is recognised that GPs have ongoing relationships with their patients and are well placed to introduce ACP. RACGP guidelines suggest that ACP should be part of routine health assessments. However, the uptake of ACP in WA remains low. The Greater Choices for At Home Palliative Care project at WA Primary Health Alliance (WAPHA) explored the barriers to ACP implementation as part of routine health assessments and developed a model to support a consistent approach to this important aspect of patient care. <h3>Main Text</h3> The need for ACP arises from the growing recognition of its importance in ensuring patient-centred care, particularly for elderly patients. Our project was developed to address the challenges faced by general practice that impact on their capacity and capability to engage in ACP with their patients. Our project has resulted in: an increased ACP capacity and capability within 9 general practices in WA an uplift in the number of routine health assessments completed where all patients were provided with ACP information. Adoption of a two-step process to facilitate completion of ACP documentation in general practice. Development of ten unique quality improvement activities aligned to the implementation of ACP in routine health assessments. These activities support evidence relating to the National General Practice Accreditation (NGPA) Scheme. Identification of system issues which impacted on general practice and has resulted in system improvements. An increase in the number of completed ACP documents <h3>Unique Contribution</h3> This study highlights the importance of ACP in general practice and provides a framework for its implementation in routine health assessments. It demonstrates that GPs, due to their ongoing relationships with patients, are uniquely positioned to initiate ACP discussions. <h3>Implications</h3> Our project has significant implications for patient care. By integrating ACP into routine assessments, GPs can ensure that care is patient-centred and aligned with individual preferences. Our project has created a process to support the implementation of ACP in routine health assessments that can be adopted by any general practice. This work has now been extended to the implementation of ACP as part of Chronic Disease management in general practice.