title: Advance care planning in palliative care: a national survey of health professionals and service managers.
abstract: OBJECTIVE
  To identify the attitudes, knowledge and practices regarding advance care planning (ACP) in palliative care.
  
  
  METHODS
  A nationwide online survey was distributed to Australian palliative care services associated with the Palliative Care Outcomes Collaboration (n=105). Seventy-three health professionals (HPs) and 59 service managers completed the survey.
  
  
  RESULTS
  Regarding ACP, 51% of service managers reported relevant policies and procedures were in place in their service and 44% included ACP in job descriptions. Most HPs were confident in undertaking ACP, including initiating discussions with patients and complying with documents; however, only 44% reported receiving ACP specific training. Although 58% of HPs reported having conversations about ACP with more than 11 patients in the past 6 months, only 44% of managers report that it is offered to most patients. Thirty per cent of HPs were aware of others not adhering to patient wishes in the past 6 months and only 43% of HPs (and 37% of managers) believed ACP is done well within their service.
  
  
  CONCLUSIONS
  This first national survey examining ACP in palliative care services demonstrates there is a need to improve systems to support ACP and to understand circumstances in which ACP wishes are not followed.
authors.affiliation: Respecting Patient Choices Program, Austin Hospital, PO Box 5555, Heidelberg, Vic. 3084, Australia. Email.
authors.forename: Marcus
authors.initials: M
authors.lastname: Sellars
authors.affiliation: Respecting Patient Choices Program, Austin Hospital, PO Box 5555, Heidelberg, Vic. 3084, Australia. Email.
authors.forename: William
authors.initials: W
authors.lastname: Silvester
authors.affiliation: Palliative Care Outcomes Collaboration, Australian Health Services Research Institute, University of Wollongong, iC Enterprise 1, Innovation Campus, University of Wollongong, Wollongong, NSW 2522, Australia. Email.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Masso
authors.affiliation: Cancer and Palliative Care Research and Evaluation Unit, School of Surgery, The University of Western Australia, M507, 35 Stirling Hwy, Crawley, WA 6009, Australia. Email.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Johnson
mesh_terms: D000328:Adult; D032722:Advance Care Planning; D001291:Attitude of Health Personnel; D001315:Australia; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care