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Patient representative bodies and the charitable sector should educate patients and families in relation to advance care planning and advocate for health care organizations and professionals to take the lead in introducing it to patients.
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Organizations should make necessary preparations for implementing advance care planning as core business by developing appropriate policies and administrative and quality assurance processes, while providing resources for training and for sufficient staff to offer advance care planning effectively.
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Staff trainers should seek to address concerns, optimize skills, and clarify processes, aiming to persuade staff of the usefulness of advance care planning and to give them confidence to start discussions with patients and their relatives.
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Professionals should develop an approach to advance care planning that is simple, individually tailored, culturally appropriate, actively involves surrogates, and explores the patient's understanding of their condition.
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When implementing advance care planning, professionals should aim to build trust with patients and their families; help the patient develop skills that will facilitate their participation in decision-making; and build confidence in surrogates for their role in speaking faithfully for the patient, should that become necessary.
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Researchers should develop robust clinical trials to investigate the impact of advance care planning on patient and surrogate decision-making and emotional burden; enactment of patient preferences for end-of-life care; recourse to life-prolonging treatments; and use of palliative care services and hospice care. The impacts of organizational context and cultural and personal values on the acceptability and feasibility of advance care planning should also be investigated.
