Healthcare Quarterly

Healthcare Quarterly 24(1) April 2021 : 60-68.doi:10.12927/hcq.2021.26463
Innovation in Care

Implementing Advance Care Planning Tools in Practice: A Modified World Café to Elicit Barriers and Recommendations from Potential Adopters

Michelle Howard, Dawn Elston, Brian De Vries, Sharon Kaassalainen, Gloria Gutman, Marilyn Swinton, Rachel Z. Carter, Tamara Sussman, Doris Barwich, Robin Urquhart, Dev Jayaraman, Peter Munene and John J. You


This paper reports findings from a modified World Café conducted at a palliative care professional conference in 2019, where input on tools to support advance care planning (ACP) was solicited from healthcare practitioners, managers and family members of patients. Barriers to ACP tool use included insufficient structures and resources in healthcare, death-avoidance culture and inadequate patient and family member engagement. Recommendations for tool use included clarification of roles and processes, training, mandates and monitoring, leadership support, greater reflection of diversity in tools and methods for public engagement. This paper illuminates factors to consider when implementing ACP tools in healthcare.



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