[AVBC 2025] Increasing the Update of Advanced Care Planning amongst Patients with End Stage Liver Disease
Care Continuum
Appropriate & Value-based Care Conference
National Healthcare Group
6 November 2025
To increase the uptake of Advanced Care Planning (ACP) amongst patients with End Stage Liver Disease (ESLD) admitted to the. The interventions show promise for improving ACP uptake, but further efforts are needed to sustain and expand these improvements.
Year Submitted: 2025
Published Date: 06 November 2025
Tags: Care Continuum, Preventive Care, Patient Education, End-Of-Life Care, Palliative Care
About this Content
Aims
To increase the uptake of Advanced Care Planning (ACP) amongst patients with End Stage Liver Disease (ESLD) admitted to the Gastroenterology (GE) General Ward from 40% to 70% in 6 months.
Background
Patients with end stage liver disease have frequent admissions to Gastroenterology with high in-hospital morbidity and mortality, ICU admissions. Many of these patients are elderly and non-transplant candidates. ACP discussions regarding goals of care often do not occur until end of life for these patients.
Methods
Implementation of interventions such as placement of brochures containing information on ACP, bedside education, use of standardized scripts in multiple languages, and active inpatient cirrhotic screening eligible for ACP.
Results
Baseline Runchart of ACP Discussed in Patients with End Stage Liver Disease showed an increase in ACP broached from 45.2% in July to 54.8% in August, but a decrease to 22.6% in September.
Conclusion
The interventions show promise for improving ACP uptake, but further efforts are needed to sustain and expand these improvements.
Lessons Learnt
Challenges included difficulties with data collection and the need for patient/NOK time to decide about ACP, often not completed inpatient, leading to outpatient follow-up in ACP clinic.
Keywords
Advanced Care Planning, End Stage Liver Disease, Gastroenterology
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) | Medical |
Applicable Specialty or Discipline | Gastroenterology, Palliative Medicine, Oncology |
Project Lead(s) | Lin Huiyu, Chen Kok Pun |
Project Member(s) | NA |
Connect with this contributor!
Lin Huiyu - huiyu_lin@ttsh.com.sg