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Monday 2 May 2016

Day One | Day Two

09:00 OPENING | Opening remarks from the Chair

09:10 KEYNOTE OPENING ADDRESS | Advance Care Planning and Shared Decision Making: First results of the Zürich MAPS TRIAL

  • Most concepts of Advance Care Planning focus on patient orientation but less on best evidence information to assist the process
  • The intervention in our RCT combined inter-professional ACP with evidence based patient decision aids
  • Experiences regarding content, concept and outcome

PD. Dr. Tanja Krones, Head Clinical Ethics, University Hospital Zürich

9:50 Hearing the Voices of the Vulnerable in End-of-Life Care Planning

This discussion is taking place against the backdrop of the SA legislation which was the first to be implemented in response to the foundational National Framework for Advance Care Directives (2011)

  • Consultation with members of vulnerable populations (CALD, Aboriginal and Torres Strait Islanders and those with advance chronic diseases) to ascertain needs and perspectives in end of life planning
  • Identifying and discussing gaps between policy and practice in vulnerable populations
  • Exploring the implications for advance care planning and directives

Associate Professor Bernadette Richards, Director, Post-Graduate Coursework Programmes, Deputy Director, Research Unit for the Study of Society, Law & Religion (RUSSLR) Adelaide Law School, University of Adelaide and President, Australasian Association of Bioethics & Health Law (AABHL)
Associate Professor Greg Crawford, Senior Consultant in Palliative Medicine and Director of Research & Education, Northern Adelaide Palliative Service and Associate Professor of Palliative Medicine, Discipline of Medicine, University of Adelaide and Deputy Chairman, Palliative Care SA Inc

10:30 Morning refreshments and networking

11:00 Connecting Care in an Ageing Society

  • Readying our healthcare system for the 21st century challenges
  • Focusing on episodes of care which does not match the reality of care
  • Crisis in care - not resources- The need for planning and individual informed decision-making
  • Embedding informed care planning in health provision
  • Professional Care Management - How and outcomes

Assoc Prof Tuly Rosenfeld, Specialist Geriatrician, National Care Management

11:40 Rapid Response Team Attendance to Hospital in Patients with a Not-for-Resuscitation Order: Triggers, Interventions and Outcomes

  • Rapid Response Team (RRT) attendance to inpatients with a preexisting Not-For-Resuscitation (NFR) order is not infrequent
  • RRT’s are likely to deliver critical care type interventions and instigated further limitation with respect to subsequent RRT activations and interventions

A/Prof Arthas Flabouris, Staff Specialist, Intensive Care Unit, Royal Adelaide Hospital

12:20 Lunch and networking break

13:20 Real World ACP for Those Who Lack Decision Making Capacity

  • The need for ACP in people who lack decision making capacity
  • The process of ACP for patients who lack DMC
  • The outcomes to date
  • The benefits for patients, families and clinicians

Xanthe Sansome, Advance Care Planning Project Manager, Metro North Hospital and Health Service, Queensland

14:00 CASE STUDY | ACP Implementation Model in a Regional Country Health Service

  • ACP Implementation model and process
  • Results of first 3 years of implementation – From less than 15 patients per year having ACP documents in their file (prior to implementation), to;
      > 30 patients in first 3 months of implementation
      > 213 patients in 2014
      > 322 patients in 2015
  • Barriers and facilitators to implementing an ACP program learnings
  • Achieving National Standards in ACP and End of Life Care

Meagan-Jane Adams, ACP Coordinator, Bendigo Health

14:40 Afternoon refreshment break and networking

15:00 De-Prescribing in Advanced Care

  • The Australian health system has a long journey ahead to improve the quality of care for end of life
  • De-Prescribing non-beneficial medicines is a core area of quality improvement
  • Wasted medicines resources could be better re-invested
  • How eHealth can support de-Prescribing
  • Mandating advanced care directives to contain de-Prescribing directives

Ian Manovel, Innovation Principal Director, Accenture ANZ

15:40 CLOSING INTERACTIVE DISCUSSION | How to Assist Patients in Communicating their Wishes to Families & Healthcare Practitioners

Facilitated by: Professor Richard Chye, Head of Palliative Care, St Vincent’s Hospital, Sydney
Assoc Prof Tuly Rosenfeld mbbs faag fracp, Specialist Geriatrician, National Care Management
Meagan-Jane Adams, ACP Coordinator, Bendigo Health

16:20 Closing remarks from the Chair

16:30 NETWORKING DRINKS | Informa invites all speakers and delegates to an informal drinks reception to discuss the day’s issues and network with their peers

Tuesday 3 May 2016

Day One | Day Two

09:00 OPENING | Opening Remarks from the Chair

9:10      INTERNATIONAL ADDRESS | A Clinicians Perspective on Palliative and End of Life Care

  • An early shift-Improving palliative care and enabling people with chronic illness to get the best out of the time they have left
  • Changing the focus-Doctors taking some responsibility and knowing the right time to let someone go
  • Home based palliative care- How can we achieve this for more patients?

Professor Richard Chye, Head of Palliative Care, St Vincent’s Hospital, Sydney


9:50 CASE STUDY | ACP-Progress and Promise

  • Implementation of a successful ACP Model
  • Electronic tool as an enabler for ACP and integrated care
  • The role of the ACP facilitator across the sector
  • Improving systems and organisation change
  • Aligning the ACP model with the triple aims causing transformational change

Karen Long, Advance Care Planning Facilitator, Clinical Specialty Nurse Counties Manukau, Health New Zealand

10.20 CASE STUDY | The Re-Working of Mainstream ACP Guidelines and Resources for Pacific Island Populations

  • The defining of ACP for Pacific peoples
  • Improving the experiences of Pacific patients and families
  • Re-positioning the conversations within Pacific culture

Jacqueline Schmidt-Busby, Project Manager, Ko Awatea, Health System Innovation and Improvement, Middlemore Hospital, New Zealand

10:50 Morning refreshments and networking break

11:10 CASE STUDY | Resolving System and Facility Barriers to Advance Care Planning across Metro South Health Queensland

Metro South Health (MSH) has implemented a strategy to increase public awareness of the advantages of advance care planning together with an electronic repository for Statement of Choices documents that can be stored, updated by the patient as required, and read by clinicians when necessary. Numerous challenges needed to be addressed during development of the MSH system; Queensland legislation mandates informed consent before withholding or withdrawing life sustaining treatments, whereas best medical practice holds that medical officers should not offer treatments that don't comply with best medical practice. Clinicians are cure focussed, constrained by time and fear medico-legal repercussions from ambiguous or poorly recorded patient wishes especially if there are concerns relating to the patient's decisional capacity at the time that the document was written. Effective communication and education needs to be systematised across all jurisdictions ensuring clinicians have easy access to contemporaneous advance care plans.

Professor Liz Reymond, Deputy Director, Metro South Palliative Care Service
Dr Leyton Miller, Advance Care Planning Registrar, Metro South Palliative Care Service

11:50 Withdrawal of Treatment

  • When can clinicians legally withdraw active treatment?
  • What are the rights of clinicians versus the rights of patients and family members?
  • What are the patient’s and family’s rights if they disagree with the decision?
  • Practical suggestions for resolving these situations

Karen Kumar, Partner, Hicksons Lawyers

12:30 How Legally Binding are Advance Care Plans?

  • Outline some of challenges faced by clinicians using advance care directives and advance care plans
  • Review of the legal position in different states and territories
  • Update on developments

Georgie Haysom, Head of Advocacy, Avant

13.10 Lunch and networking break

14.10 PANEL DISCUSSION | Healthcare Practitioners Point-of-View about End of Life Care and Decision Making-Where to from Here?

  • Care and compassion for healthcare practitioners as well as the patient
  • Guaranteeing that advance care plans of patients are followed and respected
  • Changing the landscape

Dr Leyton Miller, Advance Care Planning Registrar, Metro South Palliative Care Service
Assoc Prof Tuly Rosenfeld mbbs faag fracp, Specialist Geriatrician, National Care Management
Karen Long, Advance Care Planning Facilitator, Clinical Specialty Nurse, Counties Manukau, Health New Zealand
A/Prof Arthas Flabouris, Staff Specialist, Intensive Care Unit, Royal Adelaide Hospital

14.50 CLOSING KEYNOTE ADDRESS | Advance Care Planning; Realistic Expectation for All or Mere Rhetoric?

Is ACP the solution to people retaining control of the ends of their lives? Does ACP give people autonomy and choice? There are a number of problems that need to be addressed before ACP will be regarded by the community at large as a worthwhile investment of their time. Given less than 50% of Australians have a Will, why would they bother with an ACP?

  • Community death literacy-People avoid conversations with family/ others about values, meaning, quality of life and end of life wishes so completing an ACP is not understood or seen as a priority.
  • Understanding of the need and value of having conversations before a crisis
  • Standardising forms-A single process/document or repository to which people can go to access
  • Increasing the capacity in the community to guide a person through the process. Is there a role for community facilitators?
  • Lack of standardised regulation/legislation across jurisdictions undermines the profile of ACP
  • Closing the “gap” between end of life wishes being articulated and documented and after death care and disposal wishes being addressed

Molly Carlile AM, FACN, FAICD, Deathtalker®, National Ambassador for Dying to Know Day

15.30 Closing remarks from the Chair

15.40 Close of conference and afternoon refreshments

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