Knowledge to Practice Series: Advance Care Planning Quality: A Learning Journey of Continuous Improvement (9 Oct 2024)

​Advance care planning (ACP), according to the World Report on Ageing and Health by the World Health Organization, is an important part of caring for older people, including those who have a significant decline in their intrinsic capacity. However, practicing quality ACP is challenging and multiple barriers have been identified at different stages of the ACP process.

As part of its Knowledge to Practice Series (KPS), GERI's most recent webinar featured a series of insightful presentations from experts, including ACP Quality Implementation teams, who shared their experiences and potential strategies for overcoming these challenges.

With one in four Singaporeans projected to be over 65 by 2030, Dr Raymond Ng, Visiting Consultant, GERI, and Chief, Palliative and Supportive Care, Woodlands Health, opened the session by underscoring the need to improve ACP quality as Singapore's population ages.

Professor Ayelet Gneezy, Professor for Behavioral Sciences and Marketing, University of California San Diego, discussed potential barriers to ACP completion, emphasising the need to understand the unique perspectives of individuals, families, healthcare systems, and caregivers.

Presenting their findings on enhancing the quality of ACP documentation, Mr Roland Chong, Senior Manager, and Ms Jasmine Tan, Senior Coordinator from Tan Tock Seng Hospital's Division of Integrative and Community Care, introduced a structured ACP documentation template, which focuses on capturing key elements during ACP conversations.

A potential solution to reduce ACP rejections and increase referral rates by using an ACP introduction guide was shared by Mr Pestian Teo, an ACP facilitator with Khoo Teck Puat Hospital. The guide allowed care providers to use it as a communication tool to convey the essence and purpose of ACP more effectively to their patients.

The webinar also highlighted the importance of mentorship in improving ACP practices. Ms Liao Kehua, Advanced Practice Nurse, Woodlands Health, discussed how mentorship programmes have empowered healthcare providers to navigate the complexities of ACP conversations, fostering a supportive learning environment that builds confidence and skills.

And in her presentation on assessing community-dwelling residents' readiness for ACP discussions, Ms Ng Xiang Ling, Senior Staff Nurse, Singapore General Hospital (SGH) shared research revealing that proactive engagement by healthcare professionals is essential for normalising these conversations and improving initiation rates.

Rounding off the presentations, another SGH Senior Staff Nurse, Ms Angalaprameswary D/O Paniersalavam addressed the low ACP completion rates among medical intensive care unit (ICU) survivors, highlighting the need for more training of ICU staff to better facilitate ACP discussions for this group.

Concluding the webinar, Associate Professor James Alvin Low, Lead Scientist, GERI, and Senior Consultant in Geriatric Medicine and Palliative Care at Khoo Teck Puat Hospital, reflected on the growth of the ACP programme in Singapore over the last 15 years. He also emphasised the importance of translating research findings from journal publications into practical applications that can make a difference in real-world settings.

Organised in collaboration with the Agency for Integrated Care, the webinar provided useful insights for policymakers and healthcare professionals endeavouring to improve ACP practices and policies. It drew over 600 participants from various healthcare settings, educational institutions as well as public agencies.

A synopsis of each presentation can be found in our Knowledge to Practice Series Webinar Brief: click here [PDF, 337 KB]​.

Click here [PDF, 175 KB]​ for the programme and speakers.

For more information about the presentations, please email us at enquiry@geri.com.sg​.