Australian general practice experiences of implementing a structured approach to initiating advance care planning and palliative care: a qualitative study
End-of-life care in general practice is highly influenced by advance care planning and palliative care assessments. This study evaluated the implementation of the Advance Project, which encourages collaboration between general practices and local primary health networks for initiating advance care planning and palliative care assessments through training, education, and resources. The authors interviewed around 50 participants, including GPs, nurses, practice managers and primary health network staff. The Advance Project led to changes in behaviour and at the practice-level. It also increased staff awareness of the importance of discussing advance care planning and palliative care assessments with patients, and increased engagement with families and carers. In particular, this success was enabled by the collaborative approach between GPs and nurses, the competence of training facilitators, availability of mentors, and primary health network support. Barriers to implementation related to financial cost, workplace culture, workload, and the health system. Overall, the Advance Project was implemented effectively with positive outcomes for general practices and patients who require end-of-life care.
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