Respecting Patient Choices

What is advance care planning?

What is Respecting Patient Choices?

What is different about RPC?

Where did RPC start?

How is it being extended to the community and GPs?

Being involved as a GP – finding out more

Further information

Respecting Patient Choices is an Australian and Victorian government funded advance care planning program currently being piloted through Austin Health, Eastern Health, Northern Health, St. Vincent’s Health and into the community. 

What is advance care planning?    

Advance care planning is an opportunity for patients to have a say in the current and future health care.  It helps them to discuss, reflect upon, decide, and communicate their future health care decisions.  It ensures that their decisions are communicated to the health care workers who provide their care in the future.

Advances in medical technology, such as being on a life support machine in an intensive care unit, have given us the ability to prolong life where previously it was impossible.  What these advances have brought with them is the dilemma for doctors and family of deciding when to withhold or withdraw life-sustaining treatments which may be of limited or no benefit to the patient.  Advance care planning enables patients to take part in this discussion and decision.

Patients have the right to make decisions about their health care, now and for the future. Decision-making about medical treatment should involve being fully informed and, after being informed, some patients may choose to accept or refuse treatment.  An Advance Care Plan offers the patient an opportunity to say now what life-prolonging medical treatment they would and would not want in the future.  If in the future the patient is unable to express their wishes about treatment, their doctor and family will know what they would have wanted or how they would have liked the choices to be made.

What is Respecting Patient Choices?  

Many attempts to introduce advance care planning around the world, including Australia, have failed.  The Respecting Patient Choices Program is an innovative program that was started at Austin Health and is now being extended within Victoria and to other states and territories.

The Respecting Patient Choices Program aims to

• promote an individual’s understanding about the treatment options available to them

• assist them to document their wishes and preferences about future medical treatment, particularly end-of-life treatment, in an Advance Care Plan

• ensure this documentation is transferable so that it goes with the patient to other health care services.

The Program is partly based on powers enabled by the Victorian Medical Treatment Act (1988) and encourages patients to appoint a Medical Enduring Power of Attorney (MEPOA) called the ‘agent’.  The program also facilitates conversations between the patient, their agent and the significant people in their lives about their values, beliefs and goals in life, and, in light of their current health status, what medical treatments they would and would not want in the future.

What is different about Respecting Patient Choices?  

The Program is based on a successful program titled Respecting Choices Ò ( www.gundluth.org/eolprograms ) developed by Gundersen Lutheran Medical Foundation (GLMF) in Wisconsin, USA.  GLMF have granted Austin Health an exclusive licence for the program in Australia. 

Respecting Patient Choices is a program that has been tailored for the Australian health care system and is now being developed to meet community needs.  The Program has developed a systematic way of advising on the future treatment wishes of patients and this process is being implemented across the health sector.  The Program is supported by legally recognised documentation.

The Program

• trains health care staff to talk to patients and their families about advance care planning

• supports patients to document their wishes

• guides changes in the health care system to ensure that the wishes are followed.

Where did Respecting Patient Choices start?  

It was started at Austin Health through a grant from the National Institute of Clinical Studies to pilot the Program in a number of clinical areas within the hospital.

Following the success of the pilot at Austin Health, the Victorian government has funded an initiative to take the Program to other areas of Austin Health as well as other local health care services. This expansion is being funded through the Hospital Admission Risk Program (HARP) and has a focus on people who have a chronic or complex disease or condition.  Through the HARP Program, Northern Health, Eastern Health and St. Vincent’s Health have also been funded to undertake Respecting Patient Choices and are currently in the process of implementing the program into their centres with the support from Austin Health.

How is it being extended to the community and GPs?  

The Palliative Care Branch of the Australian Department of Health and Ageing has funded Austin Health to extend the pilot of the Respecting Patient Choices Program to 16-20 residential aged care facilities and 3 palliative care services in northeast Melbourne during 2003-5.  This involves an integrated program consisting of:

• introducing Respecting Patient Choices processes into the facilities and services

• staff training

• supporting the facilities and services to implement the processes

• involving the patients

• informing and supporting GPs

• evaluating the project.

Further information   

Contact:

Respecting Patient Choices Program

Austin Hospital

145 Studley Rd

Heidelberg  Vic  3084

Ph 9496 5660  Fax  9457 5405

Commonwealth Project Officers:

Meagan-Jane Adams

Email meagan-jane.adams@austin.org.au

and Suzanne O’Callaghan

Email suzanne.o’callaghan@austin.org.au