[AVBC 2025] Advance Care Planning (ACP) Discussion among Community Health Team (CHT) Patients with Dementia
Care Continuum
Care Process & Redesign
Appropriate & Value-based Care Conference
National Healthcare Group
3 November 2025
Improve rate of completion of ACP discussion in CHT patients with dementia from 2% to 5% (stretch goal of 10%) in 6 months. Increasing the number of ACP discussions in all patients might be a more achievable target than ACP discussions in patients with.
Year Submitted: 2025
Published Date: 03 November 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Cost Saving, Care Continuum, Quality Of Life, Preventive Care, Patient Education, Public Awareness
About this Content
Aims
Improve rate of completion of ACP discussion in CHT patients with dementia from 2% to 5% (stretch goal of 10%) in 6 months.
Background
Patients with advanced dementia often have not expressed their care preferences leading to unnecessary interventions that do not improve the patients quality of life. Prevalence of dementia is 10% in older adult population aged 60 and above in Singapore.
Methods
Interventions include raising awareness, distribution of OJT Cue cards for ACP discussion, ACP champions guiding nurses, and distribution of ACP pamphlets.
Results
Estimated cost savings due to reduction in patients admitted to ICU. Assuming stay of 1 week: $2,080/day X 7 = $14,560 per patient. Estimated savings in past 3 months: $14,560 X 6 = $87,360.
Conclusion
Increasing the number of ACP discussions in all patients might be a more achievable target than ACP discussions in patients with dementia.
Lessons Learnt
Continuing to gather feedback from nurses regarding their experiences with ACP with patients with dementia. Regular sharing of positive experiences to nurses and doctors regarding ACP for patients with dementia.
Additional Information
See poster appended
Keywords
ACP, Dementia, Care Planning, Cost Savings
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Healthcare Administration, Allied Health |
Applicable Specialty or Discipline | Geriatric Medicine, Neurology |
Project Lead(s) | Soh Ling Ling |
Project Member(s) | Soh Ling Ling |
Connect with this contributor!
Dr Soh Ling Ling - ling_ling_soh@ttsh.com.sg